Job Overview We are seeking a dedicated and detail-oriented MDS Coordinator/Case Mix Nurse to join our healthcare team. In this vital role, you will lead the comprehensive assessment and documentation of patient care needs, ensuring compliance with Medicare, Medicaid, and other healthcare regulations. Your expertise will drive clinical documentation improvement, optimize patient outcomes, and support accurate reimbursement processes. This position offers an exciting opportunity to influence quality care delivery in a dynamic environment that values innovation, collaboration, and excellence. Responsibilities Conduct thorough Minimum Data Set (MDS) assessments for long-term care residents, ensuring accuracy and completeness in accordance with federal and state regulations. Review medical records, clinical documentation, and coding to verify compliance with

ICD-10/ICD-9

coding standards and DRG (Diagnosis-Related Group) assignments. Collaborate with interdisciplinary teams—including nursing, therapy, social services, and physicians—to gather pertinent patient information for accurate case mix classification. Ensure documentation aligns with clinical standards, regulatory requirements, and Medicare guidelines set forth by the Centers for Medicare and Medicaid Services (CMS). Manage electronic health record (EHR) systems such as Epic, Cerner, or Athenahealth to document assessments and facilitate seamless data flow. Support utilization management by reviewing medical necessity of services, discharge planning needs, and optimizing patient care pathways. Educate staff on clinical documentation standards, coding practices including CPT (Current Procedural Terminology), ICD coding updates (ICD-10), and health regulation policies to maintain compliance. Experience Proven experience in long-term care facilities or skilled nursing settings with a strong understanding of MDS processes and case management principles. Demonstrated knowledge of Medicare regulations, HEDIS standards, NCQA requirements, and CMS guidelines related to clinical documentation improvement. Prior experience with EMR/EHR systems such as Epic, Cerner, or eClinicalWorks is highly preferred. Background in medical coding—specifically

ICD-10/ICD-9

—and familiarity with DRG assignment is essential. Critical care or ICU experience enhances ability to interpret complex medical records and physiology data effectively. Knowledge of hospital inpatient experience or Level I/II trauma center procedures is advantageous for comprehensive patient assessments. Strong understanding of HIPAA privacy rules, healthcare regulations at the state level, and long-term care regulations ensures compliance and confidentiality in all documentation activities. Join us as a pivotal part of our healthcare team—where your expertise will directly impact patient care quality while supporting operational excellence through meticulous documentation review and case management! #

HIB Pay:

$38.00 - $44.00 per hour

Work Location:

In person