Director of Clinical Reimbursement
Balance Life & Work with a New Career Opportunity
(LONG TERM CARE)
(SHORT TERM REHAB)
(SKILLED NURSING)
(SUB ACUTE CARE)
Now Hiring - Director or Clinical Reimbursement - (Cresskill), (NJ)
(CareOne at Cresskill)
Job Duties
The Director of Clinical Reimbursement assures the management of the Medicare, Managed Care and Medicaid reimbursement system for a region-specific number of skilled nursing facilities. Job duties include, but are not limited to:
- Implement and direct Medicare and Medicaid auditing and systems review.
- Admission pre-screening review
- Admission documentation requirement review
- Financial documentation requirement review
- Clinical documentation assessment
- Strategic selection of assessment reference dates
- MDS accuracy
- ADL score tracking
- Denials management
- RUGs management
- Provide Interdisciplinary Team Training
- Consolidated billing
- Update facilities on trends, developments, concepts and techniques in the Medicaid and Medicare fields that affect reimbursement services
- Engage facility management team in problem solving process to identify improvement opportunities and achieve solution
- Facilitate effective well-organized utilization meetings, establish productive objectives and follow through with action plans
- Evaluate performance of facility-based staff and make recommendations regarding staff assignments, assessment procedure and reimbursement systems. Ongoing evaluation of the effectiveness of reimbursement staff
- Fee schedules
- Diploma and/or Degree from credentialed school of nursing. Currently licensed as a Registered Nurse in the state of practice.
- Minimum of 5 years of experience in long term care.
- Proven knowledge of quality improvement processes with an emphasis on Medicare, Managed Care and NJ Casemix for Skilled Nursing facilities.
- Multi facility experience with management skills
- Excellent oral and written communication skills.
- Work processing and related computer skills.
- Current licensing and credentials as required.
-
Seniority level
Director -
Employment type
Full-time -
Job function
Finance and Sales -
Industries
Hospitals and Health Care
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