MDS RN

MDS Lead RNSalaried: $74,880 - $76,960, exempt (depending on experience) Equivalent to $36 - $37/hour Shift: Full-Time, DaysHarris Hill Nursing Facility is looking to add an MDS RN to its team. In this role, you'll coordinate Medicare, Managed Care, and Medicaid reimbursement activities while ensuring accurate MDS completion, regulatory compliance, and reimbursement optimization. You'll also provide education and support to facility staff while overseeing MDS processes and assisting with reimbursement-related audits and reviews. If you have experience with MDS, PDPM, and long-term care reimbursement, this could be the perfect opportunity for you.Located in the heart of Williamsville, Harris Hill Nursing Facility is proud to be part of The McGuire Group, a leader in skilled nursing and rehabilitation services throughout New York State. As a CMS 5-Star rated facility, Harris Hill is recognized for its commitment to quality care and clinical excellence. Our team is known for its collaborative culture, strong resident relationships, and dedication to helping both residents and employees thrive.Responsibilities:Provide education and support to facility staff regarding Medicare, Medicaid, Managed Care, eligibility, certification, coverage, documentation, utilization, and reimbursementAssist facilities with certification procedures, reimbursement-related processes, and resolution of problem areasCollaborate with claims review units, compliance teams, and third-party payers to ensure regulatory and company complianceAssist with the review and preparation of denied claims, audits, and administrative record reviewsAssess compliance with Medicare, Medicaid, Managed Care, and third-party payer requirements and develop corrective action plans as neededMaintain and analyze reimbursement-related statistical data and utilization trendsMonitor authorizations and compliance with third-party payer requirementsProvide ongoing education and training related to reimbursement programs and regulatory changesConduct PDPM reviews upon admission, re-admission, or as indicatedReview Medicare Part A MDS assessments for accuracy and complianceSupervise MDS LPN activities and co-sign MDS assessments completed by LPN staff as requiredGather documentation for CMS audits and other reimbursement-related auditsReview physician documentation and assist with accurate ICD-10 coding and diagnosis rankingConduct MDS integrity reviews and complete MDS assessments as neededPerform additional duties as assignedRequirements:Minimum education requirement: Associate's Degree in Nursing; Bachelor's Degree in Nursing preferredMinimum experience requirement: 2 years of long-term care experience; 4 years of long-term care experience preferredCurrent unrestricted NYS Registered Nurse (RN) License requiredExperience with MDS, PDPM, reimbursement, and quality measuresStrong understanding of Medicare, Medicaid, Managed Care, and third-party payer requirementsExcellent time management, organizational, and problem-solving skillsProven leadership skills with the ability to mentor and support team membersStrong communication and interpersonal abilitiesAbility to manage multiple priorities and meet deadlinesIn-depth knowledge of long-term care regulations, reimbursement methodologies, and standards of careAbility to provide education, training, and support to interdisciplinary teamsBenefits:Paid Time Off (PTO) for Full-Time and Part-TimeWeekly or Same-Day Pay OptionsHealth, Dental, and Vision InsuranceLife InsuranceEmployee Referral Bonus ProgramEqual Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.