CLINICAL REIMBURSEMENT COORDINATOR - RN/LPN
📋 Role Overview & Responsibilities
Essential Job Functions
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Perform independent and/or suggested affiliate level, clinical and financial audits as warranted.Identify and assist with educational opportunities through audit, tracking, trending, and analyzing relevant patient data with supervisor guidance and support.Strategic planning related to ARDs; optimizing the appropriate revenue systems.Ensure IDT compliance with state/federal requirements and timeframes related to MDS, billing and care planning.Interpretation of revenue related data as requested.Identify revenue related risks associated with missing, irrelevant, erroneous clinical documentation. Assist with action plans related to such risk as warranted.Assist with orientation and education for CRCs and other IDT members as relates to MDS and/or reimbursement processes.Provide ongoing education and communication with IDT as relates to current state and federal regulation systems driven by the MDS.Review clinical charts and assist with determination of ongoing skilled need, and appropriate Length of Stay.Under the coordination of a Registered Nurse, complete sections of the MDS.Review, revise and communicate the need for new care plans as per facility protocol.Attend CP meetings per facility protocol.Conduct/attend as necessary the daily, weekly, monthly meetings related to Revenue. (Daily REV, Wkly MRA/CMI, Monthly Triple check)Ensure/assist with the timeliness of managed care updates.Assist with maintenance, risk and education related to 5 STAR Quality Measures/Value Based Purchasing, and Quality Reporting programs.Provide information as requested for Additional Documentation Request (ADR) and appeals as appropriate.Other related duties as assigned.
Annual Salary
LPN - $70,000-$80,000
RN - $85,000-$95,000
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This position is located in Hartford County, CT with potential relocation and sponsorship assistance depending on candidate qualifications.
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