Reimbursement Services Director - Home Care directs and supervises the activities of the benefits claims and provider reimbursement personnel in a home care environment. Sets procedures for filing reimbursement claims and ensures timely and accurate claims payments. Being a Reimbursement Services Director - Home Care monitors, evaluates and reviews all cost reporting in support of reimbursement claims. Produces the documentation necessary for reimbursement, Medicare Compliance, and control of receivables. Additionally, Reimbursement Services Director - Home Care may require an advanced degree. Typically reports to top management. The Reimbursement Services Director - Home Care typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Reimbursement Services Director - Home Care typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)
Due to our recent growth we are currently interviewing for a Regional Reimbursement Specialist to add to our team in Southeastern WI!
At Champion Care, we are driven by a noble mission: to deliver unparalleled quality services to our residents and their families, empowering each resident to soar to their highest potential. Rooted in this mission, we aspire to set the standard as both a provider and employer in every community we touch.
Our principles of respect and dignity extend beyond our residents and families; they are upheld for every member of our esteemed team. Here at Champion Care, we passionately champion the wellbeing of our dedicated professionals, offering unwavering support, heartfelt recognition, and meaningful rewards.
Are you ready to make a positive impact in the healthcare industry? We're seeking an enthusiastic and driven individual to join our team as a Regional Reimbursement Specialist (Regional MDS Director). Do you have previous MDS Coordinator or Regional Director of MDS/Reimbursement experience and want to take your skills to educate, grow, and lead? This is the opportunity for you.
Locations: Beloit, Muskego, Burlington, Milwaukee x 2, Kenosha x 2
**Daily duties:**
- Review PCC clinical ADT dashboard reports to ensure accurate payers and MDS assessments.
- Identify PDPM opportunities by reviewing SNF metric progress notes.
- Serve as a supportive resource for facilities within your region.
**Weekly Duties:**
- Update CMI tracker and collaborate with facility teams to set reimbursement goals.
- Maintain ADR tracker and provide support on ADR status.
- Attend facility stand-ups, stand-downs, and Medicare meetings to ensure effective communication and compliance.
- Conduct mini audits to uphold compliance standards.
**Monthly Duties:**
- Review MDS 3.0 Missing Assessment Report to ensure CMS reimbursement accuracy.
- Verify QM and QRP audits for timeliness and accuracy.
- Participate in triple check meetings for comprehensive review.
**Quarterly Duties:**
- Conduct Quarterly Reimbursement and Quality Assurance Evaluations.
- Perform CMI audits as needed.
**Why Join Us:**
- Dynamic work environment with opportunities for growth and development.
- Competitive compensation and benefits package.
- Make a meaningful difference in the lives of patients and staff members.
**Qualifications**
-WI RN Licensure
-Previous MDS Coordinator experience, including up to Regional MDS
**Apply Now:**
If you're ready to take on a rewarding role that combines leadership, collaboration, and innovation, we want to hear from you! Submit your application today and join us in making a difference in healthcare.
Champion Care is an equal opportunity employer and is committed to diversity and inclusion in all aspects of employment. We do not discriminate on the basis of race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. We actively encourage individuals from all backgrounds to apply for employment opportunities within our organization.
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