Area of Interest : Nursing - Clinical/Nurse Consultant
Position Type : Full Time - Permanent
Relocation Approved : Yes
Recruiter : Hauxhurst, Kimberly
Job Description : The Clinical Reimbursement Manager is responsible for the Medicare/Medicaid reimbursement process through evaluating, enhancing and training Center staff to increase their knowledge and skills required to optimize revenue under each program. Participates in the development, implementation and ongoing evaluation of reimbursement priorities in the center and review outcomes.
Evaluates the Medicare and Medicaid processes monthly to assure proper utilization of services to maximize reimbursement. Monitors the centers by conducting periodic audits, such as PPS audits, and takes appropriate action to assure compliance with established standards. Advises and assists the Clinical Reimbursement Coordinators to assure compliance to HCFA and State reimbursement regulations and Genesis Policies and Procedures Presents changes in reimbursement regulations imposed on center operations through training classes developed by the Reimbursement Service Group. Participates in each center's Medicare meetings to review coverage and documentation issues and requirements at each center. Reports any issues to the Administrator, DON and Clinical Reimbursement Coordinator, as well as appropriate regional staff. Communicates with Genesis Network Services to assist in the coordination of reimbursement services provided to the HealthCare centers. Assists in the selection and orientation of new Clinical Reimbursement Coordinators as requested. Assists other RSG members as requested on development of new programs or additional tasks as assigned. Puts Customer Service First: Functions as a consultant to the centers and ensures that centers received the highest quality of service by responding timely to requests and providing support in a professional manner. Performs other duties as requested.
MCR2
Qualifications : The Clinical Reimbursement Manager must be a graduate of an approved school of nursing with a license as a Registered Nurse or equivalent professional license (i.e. Physical Therapist),A BS or a BA degree is required,the candidate must have Medicare and Medicaid experience. Multi-building oversight strongly preferred. This position is home based in California and requires up to 70% travel.
PI60472932
Position Type : Full Time - Permanent
Relocation Approved : Yes
Recruiter : Hauxhurst, Kimberly
Job Description : The Clinical Reimbursement Manager is responsible for the Medicare/Medicaid reimbursement process through evaluating, enhancing and training Center staff to increase their knowledge and skills required to optimize revenue under each program. Participates in the development, implementation and ongoing evaluation of reimbursement priorities in the center and review outcomes.
Evaluates the Medicare and Medicaid processes monthly to assure proper utilization of services to maximize reimbursement. Monitors the centers by conducting periodic audits, such as PPS audits, and takes appropriate action to assure compliance with established standards. Advises and assists the Clinical Reimbursement Coordinators to assure compliance to HCFA and State reimbursement regulations and Genesis Policies and Procedures Presents changes in reimbursement regulations imposed on center operations through training classes developed by the Reimbursement Service Group. Participates in each center's Medicare meetings to review coverage and documentation issues and requirements at each center. Reports any issues to the Administrator, DON and Clinical Reimbursement Coordinator, as well as appropriate regional staff. Communicates with Genesis Network Services to assist in the coordination of reimbursement services provided to the HealthCare centers. Assists in the selection and orientation of new Clinical Reimbursement Coordinators as requested. Assists other RSG members as requested on development of new programs or additional tasks as assigned. Puts Customer Service First: Functions as a consultant to the centers and ensures that centers received the highest quality of service by responding timely to requests and providing support in a professional manner. Performs other duties as requested.
MCR2
Qualifications : The Clinical Reimbursement Manager must be a graduate of an approved school of nursing with a license as a Registered Nurse or equivalent professional license (i.e. Physical Therapist),A BS or a BA degree is required,the candidate must have Medicare and Medicaid experience. Multi-building oversight strongly preferred. This position is home based in California and requires up to 70% travel.
PI60472932
