Job Information
Loomis Lakeside at Reeds Landing Clinical Reimbursement Specialist in Springfield, Massachusetts
Clinical Reimbursement Specialist Loomis Lakeside at Reeds Landing Springfield, MA Summary Description: Responsible for the MDS/PPs documentation and submission function. Processes and ensures MDS/PPS documentation of resident care will meet all federal and state regulations and will maximize reimbursement to The Loomis Communities. Other duties as assigned Essential Functions Performs job functions in a manner consistent with the mission and goals of the Loomis Communities. Adheres to The Loomis Communities Compliance and Ethics Program. Demonstrates an awareness of, a respect for and attention to the diversity of the people with whom they interact (persons served, personnel, families/caregivers, and other stakeholders) that is reflected in attitudes, behavior and services. Oversees, coordinates, completes and ensures electronic submission of the nursing center MDS/PPS assessment process for all residents accurately and timely with honesty and transparency. Acts as a clinical resource and collaborates with rehabilitation, nursing, clinical liaison and billing departments with fiscal prudence to maximize reimbursement, keeping residents, families and staff informed of changes. Serves on various committees and attends key meetings. Prints and audits Quality indicator reports and shares information collaboratively with appropriate departments, where indicated. Monitors and complies with safety regulations, infection control procedures and quality of care services through rounding, discussion and meetings. Participates in CARF/CCAC, OSHA, OBRA, DPH and other surveys/inspections, ensuring their readiness. Complies with confidentiality requirements and Resident Rights. Qualifications Required Education: Registered Nurse or Licensed Practical Nurse, graduate from accredited school of nursing; licensed by the Commonwealth of Massachusetts. Preferred Education: Registered Nurse, graduate from accredited school of nursing; licensed by the Commonwealth of Massachusetts, with a minimum of three years experience in LTC setting, with at least one year of clinical reimbursement experience. Required Experience: Minimum of three years experience in LTC setting, with at least one year of clinical reimbursement experience. Preferred Experience: Minimum of three years experience in LTC setting, with at least one year of clinical reimbursement experience. License(s): Licensed Practical Nurse required/ Registered Nurse Required Skills/Compentencies: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Ability to read, write, and speak English. Ability to relate well to all residents, including the emotionally upset. Ability to deal tactfully with personnel, residents, family members, visitors and the public. Ability to report to work regularly and promptly. Ability to work beyond normal hours when necessary.