Find & Apply For Clinical Auditor / Utilization Reviewer Jobs in Pittsburgh, Pennsylvania

Position Summary We are seeking an experienced and detail-oriented RN Assessment Coordinator (RNAC) to join our team. The RNAC is responsible for coordinating and completing the MDS process in accordance with federal and state regulations while ensuring accurate clinical documentation and optimal reimbursement. This role works closely with the interdisciplinary team to ensure quality resident care and compliance with all regulatory requirements. Key Responsibilities Complete and oversee all MDS assessments (admissions, quarterly, annual, significant change, PPS, OBRA, etc.) Ensure timely and accurate submission of MDS assessments Coordinate and lead care plan meetings with interdisciplinary team Ensure care plans are accurate, individualized, and updated regularly Monitor and support PDPM accuracy and reimbursement optimization Review clinical documentation to ensure it supports coding and reimbursement Collaborate with nursing, therapy, and administration to ensure compliance Participate in Medicare meetings and triple check process Maintain compliance with all CMS, state, and facility guidelines Assist with surveys, audits, and regulatory reviews Qualifications Current Registered Nurse (RN) license in Pennsylvania Minimum 1-2 years of

MDS/RNAC

experience in a skilled nursing facility Strong knowledge of:

MDS 3.0 PDPM

Medicare/Medicaid guidelines Experience with electronic medical records (EMR) systems RAC-CT certification preferred (or willingness to obtain) Skills & Attributes Strong attention to detail and organization Ability to manage deadlines and multiple assessments Excellent communication and teamwork skills Critical thinking and problem-solving abilities Strong understanding of reimbursement and regulatory compliance

Benefits:

Dental insurance Health insurance Paid time off Vision insurance

Work Location:

In person