Regional Clinical Reimbursement Specialist Metro Boston

Care One at Newton - Balance Life & Work with a New Career Opportunity(LONG TERM CARE)(SHORT TERM REHAB)(SKILLED NURSING)(SUB ACUTE CARE)CareOne is hiring for a Regional Clinical Reimbursement Specialist - Metro Boston. This is a Regional Position; expectation is the RCRS will have responsibility for up to FOUR(4) CareOne centers$140K - $155KCompensation will be based on, but not limited to, experience, qualifications, credentials and any other relevant informationThe Regional Clinical Reimbursement Specialist assures the management of the Medicare, Managed Care and Medicaid reimbursement system for a region-specific number of skilled nursing facilities. Job duties include, but are not limited to:Implement and direct Medicare and Medicaid auditing and systems review.Admission pre-screening reviewAdmission documentation requirement reviewFinancial documentation requirement reviewClinical documentation assessmentStrategic selection of assessment reference datesMDS accuracyADL score trackingDenials managementRUGs managementProvide Interdisciplinary Team TrainingConsolidated billingUpdate facilities on trends, developments, concepts and techniques in the Medicaid and Medicare fields that affect reimbursement servicesEngage facility management team in problem solving process to identify improvement opportunities and achieve solutionFacilitate effective, well organized utilization meetings, establish productive objectives and follow through with action plansEvaluate performance of facility-based staff and make recommendations regarding staff assignments, assessment procedure and reimbursement systems. Ongoing evaluation of the effectiveness of reimbursement staffFee SchedulePosition Requirements:Diploma and/or Degree from credentialed school of nursing. Currently licensed as a Registered Nurse in the state of practiceMinimum of 5 years of experience in long term careProven knowledge of quality improvement processes with an emphasis on Medicare, Managed Care and MA Casemix for Skilled Nursing facilitiesMulti facility experience with management skillsExcellent oral and written communication skillsWord processing and related computer skillsCurrent licensing and credentials are requiredCareOne Employer DescriptionThe CareOne mission is to define excellence within the health care community. We are dedicated to Maximizing Patient Outcomes. We treat Residents, their families and each other with respect, dignity and compassion. Through a collaborative and consultative approach, we strive to provide a framework of strength and stability for our Centers and Communities. We work to maintain the highest standards of care and service for Residents, families and our valued employees.We are proud to Offer:Competitive SalaryComprehensive Healthcare Benefits401k Retirement PlanPaid Time OffOpportunities to advance and grow your careerAnd MoreIf working with people who are dedicated, compassionate, and concerned about their patients is essential to you, then you'll appreciate being a part of our team. We've built a strong reputation on the outstanding level of care that we provide. We have a graciously appointed facility with strong belief in patient care and service; join us at our beautiful facility!We are an Equal Opportunity EmployerEEO/AA/M/F/DV