Duties and Responsibilities
Administer Patient Assessments
- Coordinate patient care and administer patient assessments.
- Oversee the assessment process, setting assessment schedules, review assessments and ensure that assessments are done in an accurate and timely manner.
- Make policy and procedural recommendations to the upper level management staff.
- Develop Care Plans, transmits assessments to the Department of Health.
- Coordinates the care plan as according to regulatory requirements.
- Ensure that important resources are made available to patients and that patient care is delivered effectively and to a satisfactory standard.
Coordinate Medicare and Medicaid
- Licensed RN/LPN in NJ preferred
- Create schedules for all Medicare and Medicaid.
- Start Medicare / Medicaid coverage for newly qualified patients or send out denial letters.
- Stay updated on changes in Medicare coverage and help determine documents needed for Medicaid reimbursement.
- Perform other duties as may be called upon by management.
Qualifications and Experience
- Licensed RN/LPN preferred
- Three (3) years of progressively responsible and directly related work experience.
- Prior experience in MDS coordination or health information systems preferred.
- 1-2 years of statistical analysis and medical billing experience.
- Clinical experience in a healthcare setting or group home
- Basic computer literacy
- Working knowledge of MDS 3.0
- Knowledge of State and Federal regulations
- Knowledge of Resident Assessment
- Long term care experience in a Group Home setting.
Working knowledge of government/non-government payer requirements, reimbursement rules, laws and regulations that govern billing/collection activities. Knowledge of CCI (Correct Coding Initiatives) and CMS compliance issues and clinical documentation, coding, third-party reimbursement), patient financial services (e.g., managed care contracting, claims processing, account resolution, denial management, payment posting).