Position Available:
80 hours/2 weeks
Monday-Friday Days
Full benefit package

Job Summary
The MDS Coordinator is responsible for: the overall coordination of the MDS & RAI process/maintaining effective communication between payer, physician, family, resident and team in collaboration with team members/coordinating the Medicare process/acting as the facility’s System Support Operator and Achieve Matrix Clinical Lead.

Applicants MUST complete an application rather than submitting a resume (please follow instructions below).

To apply, complete an application in person available at the Receptionist Desk at Saint Anne of Winona, 1347 West Broadway, Winona, MN 55987 or download an application by clicking on Apply Online below & then click on "Download our application here" (at this time, you will need to print out this application and mail it to Human Resources at the address listed above). 

Once we have received your application, we will send you acknowledgment that it has been received. If your qualifications match our needs, we will contact you by phone to schedule an interview. If you are not contacted for additional information or asked to come in for an interview, then you will not receive any further correspondence. No phone calls please.
 

Qualifications Required

·         Graduation from an accredited school of professional nursing

·         Current RN license to practice nursing from the Minnesota Board of Nursing

·         Current Resident Assessment Coordinator certification (RAD-CT) or successful completion after hire

·         Current CPR certification

·         Knowledge of current state and federal regulations governing long-term care facilities

·         Proficient in Microsoft Office applications, Internet and Achieve Matrix.

·         Interest in and good working knowledge of MDS, Medicare and care-planning process

·         Ability to communicate effectively with residents, families, and interdisciplinary team

·         Must be able to maintain confidentiality (HIPAA)

Qualifications Preferred

·         Previous MDS/RAI experience

·         Experience in geriatric nursing

Essential Functions of the Job, Departmental expectations

1. Coordinates the MDS/RAI process.

1.       Coordinates the MDS interdisciplinary team calendar.

2.       Insures the highest possible reimbursement for the facility by strategizing on the Assessment Reference Date of the MDS’s under PPS/MSHO.

3.       Ensure all disciplines complete the MDS and sign with appropriate dates.

4.       Manages the MDS/RAI process and transmits all MDS’s.

5.       Retrieve MN validation reports from the MN website.

6.       Assist Admission coordinator with sending out the MN Case Mix letters.

7.       Assist with CRCR process and submit to BHS Clinical Reimbursement Specialist monthly.  (This can be a part of chart Audits)

2. Maintains effective communication between, payer, physician, family, resident, and team in collaboration with team members.

1.       Collaborates with Administration, Interdisciplinary team, and accounts receivable to capture all services delivery cost/charges, including managed care contracts.

2.       Participate with interdisciplinary team to accept resident for admission based on treatment needs, cost-analysis, and bed availability. 

3.       Analyzes services/interventions with Interdisciplinary team during course of treatment and makes adjustments needed to improve outcomes and assure reimbursement.

3. Coordinates Medicare Process

1.       Lead Medicare meetings.

2.       Maintain Medicare/insurance spreadsheet.

3.       Provide Medicare spreadsheet information to Billing staff, Admissions Coordinator, Activity staff, Restorative staff, Social Services, Director of Nursing, Nursing staff, Therapy staff, Administrator, and vendors as appropriate.

4.       Flags resident (s) chart (s) as appropriate to designate Medicare/MSHO.  Place charting note in resident (s) chart (s) for staff documentation as appropriate. 

5.       Act as a source of information and guidance for the DON and staff.

6.       Monitors resident (s) charts (s), physician orders etc, as needed to determine if continued coverage is appropriate. 

7.       Informs responsible party 48 hours before coverage ends when Medicare/MSHO coverage is no longer appropriate.  Issues non-coverage notice/denial to responsible party.

8.       Informs responsible party within 24 hours before coverage ends when Medicare/MSHO coverage is no longer appropriate and per Medicare guidelines.  Issues Generic denial to resident (s) responsible party.

9.       Assist Admissions Coordinator with completing and sending physician Medicare certifications per required guidelines.

10.   Process demand bills to appropriate staff as requested by beneficiary or responsible party and forward to billing.

11.   Assist Admission Coordinator with sending in chart information for MREP to be reviewed. Process demand bills that might be requested by MREP for dual eligible residents (MA and Medicare/MSHO).

12.   Complete Medicare review audits as requested by Medicare.

13.   Follow residents no longer covered by Medicare for 30 days after the end of coverage to determine if coverage should be resumed; resume if appropriate

14.   Follow residents who are benefit exhausted, who go 60 days without a daily skilled services and notify Medicare Biller, when they can re-qualify for Medicare A/MSHO benefits.

15.   Assist Station Secretaries and Admission Coordinator with ICD-9 coding and sequencings.

4. Helps with computer issues as they arise as an SSO (System Support Operator) and Achieve Matrix Clinical Lead.
5. Other duties:  Completes all other duties as assigned.