Corporate Clinical Reimbursement Manager

Corporate Clinical Reimbursement Manager Presbyterian Senior Living - Administrative Office

Dillsburg, PA FLSA Status:

Exempt FTE:

1.0 = 80 hours per pay,

Full Time Holidays:

No Holidays On Call:

No Schedule:

8am-4:30pm

Shift:

Days Status:

Full Time Weekends:

No Weekends Turn your clinical experience into impact in a role where clinical expertise meets opportunity! Presbyterian Senior Living is a mission-driven organization that lives our values of fostering teamwork, upholding integrity, embracing innovation and leading with compassion in all that we do. Our legacy of serving more than 6,000 older adults with respect and dignity for over 95 years supports our mission to promote wholeness of body, mind and spirit for all that live within our communities. If you are compassionate, driven and enjoy working with an organization that is committed to valuing the diversity of all team members, one that offers a variety of schedules, career development, excellent benefit options, and more; PSL is for you! Whether you are a nurse, caregiver, culinary professional, maintenance worker or looking for a new career, we offer a wide range of career opportunities to fit your skills and interest. The Corporate Clinical Reimbursement Manager is responsible for establishing and supporting clinical documentation systems related to MDS documentation, value-based reimbursement payment models and staff scheduling systems. This position reviews community clinical information processes, documentation, and consults with Executive Directors/Health Care Administrators and community staff as required. This position is also required to participate in projects requiring integration with vendors, information technology teams, clinical and financial teams.

Qualifications:

Registered Nurse with a Bachelor's degree in Nursing required Minimum of 3 years' experience in the MDS process, quality improvement, and clinical documentation systems required Demonstrated ability to manage projects and priorities Strong technical expertise and knowledge of clinical health technologies Demonstrated ability to interact with all categories of staff and stake holders of a multi-community organization; includes: Trustees, staff, resident regulators, residents, family members, surveyors and other health care providers Ability to travel to PSL communities/locations and partner sites required Current and valid driver's license required

Expectations:

Monitors all Clinical Documentation systems and works with community and corporate staff to assure that documentation supports the billing and reimbursement received. Develops paper clinical documentation which assures regulatory and reimbursement compliance and provides efficient and effective use of PSL resources. Knowledge of Quality Measures and Five Star Rating system. Monitors all clinical documentation systems and works with community and AO Staff to assure that all documentation is appropriate and supports the services provided. Coordinates and conducts RNAC orientation/competencies as they relate to corporate process/performance. Consults, guides and educates PSL staff on all EHR documentation requirements to support clinical reimbursement in concert with the Vice President of Clinical Excellence and the VP of Compliance/Privacy Officer. Reports findings of site visits and assists communities with the development of plans for correction. Works cooperatively with the Corporate Director of Compliance/Privacy Officer in developing, evaluating and amending policies and procedures for compliance. Responsible for the development, implementation and monitoring of PSL's Restorative Nursing Program. Develops regulatory compliant coding standards in cooperation with the Medical Records staff within communities to ensure compliance with billing requirements.