Director of Reimbursement

Our mission is Dignity in Life. We are "Family Serving Family," guided by our values of Serving, Integrity, Teamwork, and Excellence. You will be part of a highly respected team of skilled and caring people committed to making quality service a way of life.

• →Review current Medicare and Medicaid programs and MDS systems to identify strengths and opportunities for improvement.
• →Ensure all services are captured for appropriate reimbursement.
• →Set standards and benchmarks for Medicare Part A & B utilization that maximize reimbursement while meeting all regulatory requirements.
• →Review, set guidelines and develop tools to manage the financial impact of the admission process.
• →Analyze ADL coding, assess accuracy, and identify miscoding or under-coding that could contribute to lost revenue.
• →Develop comprehensive ADL training for all staff, along with ongoing competency tests and audits.
• →Develop and maintain PDPM and RUG education, including RUG distribution, assessment reference date selection, interdisciplinary communication, and timely MDS submission to meet billing timeframes.
• →Develop training programs as legislation changes and serve as a teacher, model and consultant for other staff.
• →Manage education related to iQIES reports and Quality Metrics.
• →Build cooperative working relationships with other departments and uphold safety, regulatory, and company standards.

• Ten years of work experience as an RN and five years working with Medicare and MDS.
• Excellent background in Medicaid and Medicare rules and MDS functions, and good working knowledge of nursing home regulations.
• Proven training experience and a solid knowledge base of geriatric health care.
• Sound judgment and technical skills; able to meet deadlines and manage several projects simultaneously.
• Effective verbal and written communication with personnel, professionals, business contacts and the public.
• High personal integrity, a caring attitude and a strong desire to relate to and work with others.