Salary Rate: $90,000
Establish and maintain partnerships with operations and clinical leadership to support MDS and reimbursement processes.
Promote effective use of clinical technologies including PointClickCare (PCC) to support documentation accuracy.
Provide end-user support and training related to clinical systems and MDS processes.
Facilitate system training for new implementations and optimization initiatives.
Collaborate with system analysts to develop enhancements that improve workflow and clinical outcomes.
Conduct routine audits of OBRA and PPS (Cert/Recert) assessments to ensure scheduling compliance with CMS regulations.
Perform random audits of completed MDS assessments to validate accuracy, supporting documentation, and reimbursement optimization.
Review Medical Review (MR) packages prior to submission to reduce risk of denials.
Provide support for ADRs, denials, and appeal processes as needed.
Review CMS reports (CASPER, Roster, Admission/Discharge) and reconcile against PCC data to ensure accuracy and identify gaps.
Monitor CMS QRP Preview Reports to mitigate risk of 2% APU penalty.
Monitor VBP performance indicators including readmissions, infections, and other CMS quality measures.
Review Net Health/PointRight alerts to identify coding inconsistencies, missing data, and QM risks.
Review validation warnings/errors and confirm appropriate corrective action has been taken.
Support onboarding and training of MDS Coordinators and medical records staff.
Provide ongoing education related to CMS regulatory updates and RAI Manual changes.
Maintain data integrity, security, and HIPAA compliance.
Develop reports and track clinical, regulatory, and reimbursement metrics.
Perform other duties as assigned.
Level of Formal Education: Bachelor’s degree preferred or work-related experience
Area of Study: Healthcare Administration, Nursing, or related field
Years of Experience: 3+ years
Type of Experience: SNF/LTC operations, MDS, EHR implementation, reimbursement processes
Special Certifications: MDS certification preferred (RAC-CT or equivalent)
Language Skills: Strong written and verbal communication skills
Skills and Ability: Skilled Nursing / Long-Term Care expertise; Medicare reimbursement knowledge; MDS coding; EHR systems (PointClickCare preferred); strong analytical and auditing skills; training capability; attention to detail
Senior Lifestyle offers a comprehensive benefits plan to eligible team members including health, dental, vision, retirement benefits, short-term disability, long-term disability, and paid time off. All Senior Lifestyle positions are eligible to use DailyPay, an application that allows you to access your earned but unpaid wages before your next payday.
Job details are sourced from the employer's original posting.
Open job postingAbout the company
Do you have HEART? We are looking for individuals who can embrace our mission to purposely brighten and enrich the lives of those we serve with HEART; Hospitality, Excellence, Appreciation, Respect & Teamwork. In this role you will get to express your creativity and enthusiasm for life as you assist the Resident Program Director in creating, initiating, facilitating, and coordinating recreational and educational activities for the resident of the community.