Reimbursement Services Director - Home Care jobs in Mississippi

Reimbursement Services Director - Home Care directs and supervises the activities of the benefits claims and provider reimbursement personnel in a home care environment. Sets procedures for filing reimbursement claims and ensures timely and accurate claims payments. Being a Reimbursement Services Director - Home Care monitors, evaluates and reviews all cost reporting in support of reimbursement claims. Produces the documentation necessary for reimbursement, Medicare Compliance, and control of receivables. Additionally, Reimbursement Services Director - Home Care may require an advanced degree. Typically reports to top management. The Reimbursement Services Director - Home Care typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Reimbursement Services Director - Home Care typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Area Director of Clinical Reimbursement
  • Diversicare Healthcare Services
  • Tupelo, MS FULL_TIME
  • Job ID: 2024-56435 Type: Regular Full-Time Location Name: Diversicare of Tupelo, LLC Address: 2273 South Eason Blvd Location: US-MS-Tupelo Additional Posting Locations: US-MS-Jackson | US-MS | US-MS-Batesville

    Overview

    Diversicare is a premier provider of post-acute care services to patients and residents at 43 skilled nursing and long-term care centers in five states. Together, with our team of dedicated healthcare professionals, we leverage our diverse strengths to provide each patient and resident with healthcare serves that best meet their needs.

    It is Diversicare’s Mission to “Improve every life we touch by providing exceptional healthcare and exceeding expectations.”

    Diversicare has an exciting opportunity for an Area Director of Clinical Reimbursement. In this role you will provide guidance and consultation of all aspects of the RAI process to assist facilities in meeting regulatory compliance. Additionally provide subject matter consultation on Medicare, Medicaid and Managed Care reimbursement and regulatory guidelines.

    Responsibilities

    The key role of the Director of Clinical Reimbursement is to ensure that the RAI process at each facility is being completed/coordinated in a timely and accurate manner that is in compliance with federal and state regulations. In addition to these responsibilities, the following expectations, which are not all-inclusive, will guide the Area DCR:

  • Train and consult with RNACs and LNACs on the RAI, Medicare, Medicaid and Managed Care processes to facilitate compliance, integrity and accurate reimbursement.
  • Train and consult with center staff and administration on the RAI, Medicare, Medicaid and Managed Care processes to facilitate compliance, integrity and accurate reimbursement.
  • Function as the subject matter expert for the regional team on the RAI, Medicare, Medicaid and Managed Care processes
  • Utilize Electronic Health Record and other available data systems to audit and monitor integrity of:
      • PDPM HIPPS modifier trends
      • RUG Trends in case mix states
      • ALOS
      • ADL Coding Accuracy
      • Overall RAI process
      • Identification and resolution of data integrity issues
      • Medicare, Medicaid and Managed Care program requirements
      • Medicare, Managed Care and Medicaid rates
  • Utilize Electronic Health Record and other available data systems to analyze and project Medicare, Managed Care, and Medicaid rates to facilitate accurate identification of provided services.
  • Review and analyze QM reports, investigate trends, and assist facilities in development and completion of plans to influence improvement.
  • Train and consult with centers on Medicare, Medicaid and Managed care Documentation Requests to ensure prompt response and corrective action.
  • Support Centers in retention and recruitment of MDS staff:
      • Complete second level interviews
      • Orient and provide ongoing training
      • Provide recommendations for performance assessment to administrator
  • Participate in Regional meetings and activities:
      • Quality Reviews
      • QAPI
  • Participate in Clinical Reimbursement Department Activities:
      • Program Development
      • Trainings
  • In the absence of a center NAC, Area DCR will provide direct center support which may include completion of tasks assigned to the NAC. This support may be onsite or remotely depending upon the need.
  • Other duties as assigned by leadership.
  • Qualifications

    1. Current RN license by State Board of Nursing.2. Minimum of 3 years’ experience as an MDSC.3. Prior experience in multi-facility consultation.4. Excellent communication skills; prior experience in teaching/training preferred.5. Computer skills necessary.6. Must obtain AANAC RAC-CT certification within 1 year of acceptance of position or Relias CMAC certification.

  • Just Posted

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Reimbursement coordinator
  • Enhabit Home Health & Hospice
  • Hattiesburg, MS FULL_TIME
  • Overview Enhabit Home Health & Hospice is hiring a home health billing & collections specialist to join our team as a Reimbursement Coordinator. Reimbursement Coordinators are responsible for home hea...
  • 2 Days Ago

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Reimbursement coordinator
  • Enhabit Home Health & Hospice
  • Tupelo, MS FULL_TIME
  • Overview Enhabit Home Health & Hospice is hiring a home health billing & collections specialist to join our team as a Reimbursement Coordinator. Reimbursement Coordinators are responsible for home hea...
  • 2 Days Ago

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Home Care Aide
  • Personal Care Services MidSouth, LLC
  • Laurel, MS FULL_TIME
  • Job descriptionWe are looking for a compassionate Home Health Aide to provide assistance in daily living and personal care services in patients homes in accordance with an established care plan.Respon...
  • 18 Days Ago

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Home Care Aide
  • Personal Care Services MidSouth, LLC
  • Gulfport, MS PART_TIME
  • Job description We are looking for a compassionate Home Health Aide to provide assistance in daily living and personal care services in patients homes in accordance with an established care plan. Resp...
  • 18 Days Ago

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Home Care Aide
  • Personal Care Services MidSouth, LLC
  • Meridian, MS PART_TIME
  • Job description We are looking for a compassionate Home Health Aide to provide assistance in daily living and personal care services in patients homes in accordance with an established care plan. Resp...
  • 8 Days Ago

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Home Care Director RN
  • HCBS Owensboro KY AFAM 2
  • Henderson, KY
  • We are currently hiring an RN Home Care Director to join our team in Owensboro, KY! LHC Group is a leader in post-acute ...
  • 4/26/2024 12:00:00 AM

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Deputy Executive Director - Virtual Express Care (Director Health Care Standards), Quality & Safety
  • NYC Health + Hospitals
  • New York, NY
  • About NYC Health + Hospitals: Empower Every New Yorker — Without Exception — to Live the Healthiest Life Possible NYC He...
  • 4/25/2024 12:00:00 AM

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Resident Care Director Memory Care RN/LPN
  • Benchmark Senior Living
  • North Hampton, NH
  • Join us at Benchmark at Rye as the Resident Care Director! Joining the Benchmark Senior Living team means putting your p...
  • 4/24/2024 12:00:00 AM

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Deputy Executive Director - Virtual Express Care (Director Health Care Standards), Quality & Safety
  • NYC Health + Hospitals
  • New York, NY
  • About NYC Health + Hospitals: Empower Every New Yorker Without Exception to Live the Healthiest Life Possible NYC Health...
  • 4/22/2024 12:00:00 AM

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Deputy Executive Director - Virtual Express Care (Director Health Care Standards), Quality & Safety
  • Nyc Health + Hospitals
  • New York, NY
  • About NYC Health + Hospitals: Empower Every New Yorker Without Exception to Live the Healthiest Life Possible NYC Health...
  • 4/22/2024 12:00:00 AM

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Memory Care Director
  • Sunrise Senior Living
  • Pittsburgh, PA
  • Overview The Reminiscence Coordinator is responsible for providing overall leadership and management of the reminiscence...
  • 4/19/2024 12:00:00 AM

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Resident Care Director- RN
  • Sunrise Senior Living
  • Issaquah, WA
  • Overview The Resident Care Director (RCD) serves as the nursing clinical leader for the community and is responsible to ...
  • 4/8/2024 12:00:00 AM

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Assistant Director of Care
  • Wallick Communities
  • Traverse City, MI
  • Description Joining the Wallick Senior Living team as the Assistant Director of Nursing is your opportunity to make an i...
  • 3/1/2024 12:00:00 AM

Mississippi is bordered to the north by Tennessee, to the east by Alabama, to the south by Louisiana and a narrow coast on the Gulf of Mexico; and to the west, across the Mississippi River, by Louisiana and Arkansas. In addition to its namesake, major rivers in Mississippi include the Big Black River, the Pearl River, the Yazoo River, the Pascagoula River, and the Tombigbee River. Major lakes include Ross Barnett Reservoir, Arkabutla Lake, Sardis Lake, and Grenada Lake with the largest lake being Sardis Lake. Mississippi is entirely composed of lowlands, the highest point being Woodall Mountai...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Services Director - Home Care jobs
$62,899 to $89,767

Reimbursement Services Director - Home Care in Queens Village, NY
You can also contract for short-term collections services, consulting, or staff training to meet your unique business needs.
January 29, 2020
Reimbursement Services Director - Home Care in Moline, IL
A health care agency is not obligated to pay this amount, though you may be entitled to declare reimbursement as income and deduct vehicle expenses using the IRS mileage rate.
February 24, 2020
Reimbursement Services Director - Home Care in Des Moines, IA
The reimbursement policies for health care agencies vary widely, so know agency policy and how much driving you can expect before accepting a job.
February 22, 2020