Clinical Reimbursement Auditing Nurse
- Perform PDPM accuracy and opportunity reviews to ensure compliance and maximize reimbursement.
- Conduct Case Mix audits and validate data integrity across multiple facilities.
- Analyze MDS submissions for accuracy, consistency, and compliance.
- Collaborate with facility staff to provide feedback, education, and recommendations.
- Identify trends and assist in developing corrective action plans when necessary.
- Maintain up-to-date knowledge of CMS regulations and reimbursement guidelines.
- Active Compact RN License required.
- Minimum 2 years of MDS/Clinical Reimbursement experience in a skilled nursing facility setting.
- Strong working knowledge of PDPM, Case Mix, and Medicare/Medicaid guidelines.
- Multi-state reimbursement experience strongly preferred.
- Excellent attention to detail, organizational skills, and ability to meet deadlines.
- Proficient in electronic medical record (EMR) and MDS software.
- Fully remote role with flexible scheduling.
- Competitive compensation package.
- Opportunities for professional growth and continuing education.
- Supportive and collaborative work environment.
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