Clinical Reimbursement Coordinator/MDS Coordinator

Piscataway, New Jersey
Based on Experience
Dec 06, 2017
Jan 06, 2018
Contract Type
Full Time

This position requires an expertise in the MDS/PPS audit process and the ability to affect solutions to identified issues/problems. Responsibility includes the accurate and timely completion of all Medicare/Medicaid case-mix documents in order to assure appropriate reimbursement for services provided within the Center. In addition, this position will be responsible for mentoring new Clinical Reimbursement Coordinators in their Center as well as other Genesis HealthCare Centers as required. Must possess a basic knowledge of billing, cost containment, per diem rates, ancillary cost and utilization management.



In addition to the responsibilities/accountabilities of the Clinical Reimbursement

Coordinator position, the Clinical Reimbursement Analyst will be responsible/

accountable for the following:


1. Mentors new Clinical Reimbursement Coordinators to increase their knowledge

base of the position requirements;

2. Acts as a resource for Clinical Reimbursement Coordinators regarding clinical

computer related issues and education;

3. Analyzes reimbursement strategies implemented in the Center and reports on the

outcomes of those strategies;

4. Audits medical record documentation to validate that the documentation supports

the MDS coding and provides training to Center staff to improve documentation;

5. Monitors the cost of services prior to delivery and manages duplicate or

unnecessary services in collaboration with physicians and interdisciplinary team to

preserve per diem revenues and mange the costs of case-mix customers;

6. Identifies Center and regional educational needs related to the MDS process and

participates in training as appropriate;

7. Reviews ICD-9 coding on MDS, medical record and billing statement to reduce billing

errors and ensures appropriate documentation to support medical review;

8. Manages other case-mix staff in the Center by participating in the evaluation and

ongoing quality of their work (i.e., CRCs, MDS coordinators, or other state casemix


9. Provides feedback to Reimbursement Services and other Corporate members

concerning issues regarding the Clinical Reimbursement Coordinator position.

SPECIFIC EDUCATIONAL/VOCATIONAL REQUIREMENTS: 1. Graduate of an accredited School of Nursing with current RN licensure in the state in which employment occurs is required. 2. Two years of long term care clinical nursing experience plus successfully acting in the Clinical Reimbursement Coordinator position for one year is required. 3. Management experience also desired. 4. A Bachelor's of Science in Nursing is preferred. 5. Experience with Medicare/Medicaid reimbursement, MDS completion, clinical resource utilization and/or case management is highly desirable. 6. Additional studies in Business, Accounting or Finance are highly desirable. 7. This position requires that the employee is able to read, write, speak and understand the spoken English language to ensure the safety and wellbeing of our patients and visitors at the work site when responding to their medical and physical needs. 8. Maintains current BLS/CPR certificate (excluding ALFs/ILFs).

For more information or questions on how to apply contact:


EEO/AA, M/F, Vet, Disabled      

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