MDS &CLINICAL REIMBURSEMENT COORDINATOR - JONES COUNTY REST HOME

Job Description

Job Description

Job Title

MDS & Clinical Reimbursement Coordinator

Department

Long-Term Care

Full Time/PRN

Full Time

Job Summary

Responsible for coordinating the Resident Assessment Instrument (RAI) process, including MDS assessments, CAAs, care planning, Medicare and Medicaid reimbursement oversight, PDPM management, Quality Measure monitoring, and regulatory compliance.

Minimum Qualifications

• Current unencumbered RN license in Mississippi preferred; LPN may be considered based on experience.
• Minimum of two years of long-term care experience.
• RAC-CT certification or obtained within one year.
• Experience with MDS 3.0, RAI process, and Medicare/Medicaid reimbursement preferred.
• Knowledge of CMS regulations, PDPM, Quality Measures, and survey requirements.
• Strong organizational, analytical, and communication skills.

Preferred Qualifications

• RAC-CT certification.
• Previous MDS Coordinator experience.
• Experience with CASPER reporting, Five-Star Rating System, and QAPI processes.

Essential Duties & Responsibilities

• Serve as subject matter expert for MDS, RAI, PDPM, Medicare reimbursement, and Quality Measures.
• Coordinate interdisciplinary assessment and care planning processes.
• Ensure accurate and timely completion and submission of all MDS assessments.
• Maintain MDS assessment calendars and monitor reimbursement accuracy.
• Analyze CASPER, Quality Measure, and Five-Star reports and support outcome improvement.
• Audit records to ensure documentation supports MDS coding and billing.
• Participate in Medicare Triple Check meetings, QAPI, surveys, and compliance activities.
• Provide education and guidance to staff regarding MDS coding and documentation.
• Facilitate resident-centered care planning processes.
• Perform other duties as assigned.

Professional Responsibilities

• Maintain current knowledge of federal and state long-term care regulations.
• Participate in continuing education and professional development.
• Represent the organization professionally and positively.
• Support staffing needs as required.
• Communicate effectively with residents, families, staff, and regulatory agencies.

Physical Requirements

• Ability to sit, bend, stoop, kneel, crouch, and perform overhead lifting.
• Ability to lift and carry more than 50 pounds.
• Ability to perform common physical movements as required for the position.

ADA Statement

All candidates must be able to perform the essential functions of this position. Reasonable accommodations will be made for qualified individuals with disabilities in accordance with the Americans with Disabilities Act (ADA).

EOE Statement

South Central Regional Medical Center is an Equal Opportunity Employer and does not discriminate based on race, color, religion, sex, national origin, age, disability, genetic information, or any other protected status under applicable law.