MDS Coordinator

Regional MDS Coordinator

The Regional MDS Coordinator is responsible for overseeing MDS processes, PDPM optimization, and reimbursement integrity across assigned facilities. This role provides clinical, regulatory, and operational support to ensure accurate coding, timely submissions, and maximized reimbursement while maintaining compliance with all CMS guidelines. The position also serves as a key resource for education, auditing, and interim facility support.

Key Responsibilities

PDPM & Reimbursement Oversight

• Maintain and update the Regional PDPM Review Spreadsheet to ensure accurate tracking of all PDPM-related data.
• Review key reimbursement drivers (e.g., clinical conditions, functional status) to determine optimal Assessment Reference Dates (ARDs); utilize available tools or services as needed.
• Identify opportunities for Interim Payment Assessments (IPAs) and ensure appropriate implementation.
• Ensure compliance with CMS-required timeframes for MDS completion and submission.
• Verify that complete and accurate clinical documentation is obtained from hospitals for all admissions.
• Monitor and validate diagnoses for accuracy, appropriateness, and alignment with reimbursement and care planning.
• Review and track Utilization Review (UR) sheets weekly to ensure alignment between clinical status and payer coverage.
• Ensure appropriate issuance and accuracy of beneficiary notices, including NOMNC and ABN, when applicable.

MDS Completion & Clinical Support

• Provide direct support in completing MDS assessments during staffing shortages, vacations, or open MDS Coordinator positions.
• Provide RN signature on MDS assessments as required to ensure regulatory compliance (if applicable).
• Deliver ongoing education and guidance to facility MDS staff and interdisciplinary team members on best practices, regulatory updates, and documentation accuracy.

Quality Measures & Team Collaboration

• Support the Regional MDS Director in monitoring and improving Quality Measures (QMs), including follow-up and coordination for analysis and action planning.
• Participate in weekly meetings with the Regional MDS Director to review performance, address challenges, and develop strategies.
• Attend and actively engage in monthly MDS team meetings to align with organizational initiatives, share best practices, and address system-wide opportunities.

Auditing & Additional Support

• Assist in completing requested audits to ensure compliance and identify opportunities for improvement.
• Review and sign MDS assessments as needed.
• Support the Regional MDS Director with additional tasks, special projects, and operational needs as assigned.

Qualifications

• Active Registered Nurse (RN) license (preferred/required based on organization needs)
• RAC-CT certification preferred
• Minimum 35 years of MDS experience in a skilled nursing facility
• Strong knowledge of PDPM, CMS regulations, and reimbursement systems
• Experience with MDS software systems and clinical documentation review
• Strong analytical, organizational, and communication skills
• Ability to travel regionally as needed

Competencies

• Regulatory compliance expertise
• Clinical reimbursement optimization
• Critical thinking and problem-solving
• Leadership and team support
• Time management and adaptability