- Hopewell Junction, New York, United States
- Full-time
- $77K–$87K per year
- 2–4 years
Provide education and support to facility staff regarding Medicare, Medicaid, Managed Care, eligibility, certification, coverage, documentation, utilization, and reimbursement while overseeing MDS processes and assisting with reimbursement-related audits and reviews.
Compensation
MDS RN Salaried: $76,960-$87,360 (depending on experience) Equivalent Hourly: $37-$42/hour Shift: Full-Time
Responsibilities
- Provide education and support to facility staff regarding Medicare, Medicaid, Managed Care, eligibility, certification, coverage, documentation, utilization, and reimbursement
- Assist facilities with certification procedures, reimbursement-related processes, and resolution of problem areas
- Collaborate with claims review units, compliance teams, and third-party payers to ensure regulatory and company compliance
- Assist with the review and preparation of denied claims, audits, and administrative record reviews
- Assess compliance with Medicare, Medicaid, Managed Care, and third-party payer requirements and develop corrective action plans as needed
Requirements
- Associate's Degree in Nursing
- Bachelor's Degree in Nursing
- Nice to have: Bachelor's Degree in Nursing