Clinical Reimbursement Specialist

Overview

MDS Solutions, a division of Key Rehabilitation, is looking for fun, energetic, and self-driven team members to join our remote MDS division as a Clinical Reimbursement Specialist. A minumum of a Bachelor's degree in nursing or therapy is required.

The Clinical Reimbursement Specialist (CRS) is responsible for project work for clients such as, RAI assessments, Care Plan development, education and training to the MDS Coordinators in the facilities on the Resident Assessment Instrument (RAI) process in accordance with the laws, regulations, and company standards. The CRS also reviews reimbursement systems for PDPM and Case Mix reimbursement to ensure appropriate reimbursement and assists contracts with interim long term and short team coordination and completion.  

What do we offer you?

• Creative, fun, and flexible working environment
• The following benefits:
• Competitive salaries and bonuses.
• Promotion/Transfer/Advancement opportunities.
• Meaningful work and job satisfaction.
• Reasonable working hours.
• CE opportunities.
• Paid time off.
• Comprehensive health, dental, and life insurance 
• 401K with discretionary match 
• Mileage and licensure reimbursements 
• Flexible Spending Account and HSA 

Responsibilities

• Serve as an advisor for healthcare agencies and facilities
• Assist clients with assessing, planning, developing, and implementing systems, processes, surrounding reimbursement as requested and contracted by the client
• Consult and provide technical or interim MDS management assistance to providers as requested by the client
• Maintain current knowledge in professional standards of clinical care, federal and state statutes / regulations, QM measures and RAI process
• Provide professional, quality-driven services, including but not limited to reimbursement optimization, education, research, analysis of healthcare systems and processes, creative problem-solving and recommendations, and written presentations to clients
• Identify training needs; plan and conduct training/in-services as requested
• Function within scope of work as defined by the client
• Maintain client confidentiality and function within HIPAA regulations

Qualifications

• Graduate of an accredited college or university with at least a Bachelor’s degree in a nursing or therapy discipline and a minimum of five (5) years’ experience in a clinical position, with 3 years experience with the RAI process. 
• Must have current and unrestricted RN or Therapist (OT, PT or SLP) License. 
• Must have current RAC-CT certification. 
• Must have critical thinking skills with the ability to make good decisions and exercise sound clinical and professional judgment, with proven knowledge of quality improvement concepts and processes.
• Demonstrates strong leadership and interpersonal skills.

Key Rehab is an equal opportunity employer/service provider.