MDS Coordinator RN. - Care One Enterprise.

We are seeking a Clinical Reimbursement Coordinator for our Skilled Nursing and Assisted Living facility in Livingston, NJ. This role involves ensuring compliance with Medicare and Managed Care reimbursement policies, reporting to the facility Administrator, and collaborating with the Regional Clinical Reimbursement Specialist. Key responsibilities include conducting MDS reviews, maintaining regulatory compliance, facilitating meetings, and managing the Medicare appeals process.

Essential Duties:

• Uphold professional standards and company Code of Conduct.
• Conduct daily and weekly Medicare meetings.
• Complete MDS assessments and care plans as required.
• Ensure compliance with state and federal regulations.
• Communicate issues promptly with the facility team.
• Manage Medicare appeals and participate in hearings as needed.

Position Requirements:

• Graduate of an approved RN program with a current RN license.
• Prior experience in Medicare reimbursement and MDS preferred.
• Strong communication and organizational skills.
• Knowledge of quality improvement processes and the 5 Star report.