Clinical Reimbursement Specialist
Life Care Centers of America
Georgia, North Carolina, Tennessee

Position Summary

The Clinical Reimbursement Specialist (CRS) provides education and training to facilities on the resident assessment instrument (RAI) process in accordance with all laws, regulations, and LCCA standards. Reviews and coordinates PDPM and case mix data for the division to ensure appropriate utilization of available resources. Reports to Director of Clinical Reimbursement.

Education/Experience

• Nursing degree (RN) from accredited college
• Active nursing license
• Extensive knowledge of the RAI process, Medicare Regulations, Quality Measures, Quality Reporting and PDPM

Job Requirements

• Excellent verbal and written communication skills
• Proficient in Word, Excel, and email
• Willing and able to travel extensively
• Ability to provide education to professional and non-professional staff
• Excellent computer software skills
• Involved in community health matters/projects as appropriate
• Knowledgeable of nursing practices and procedures as well as laws, regulations, and guidelines governing nursing functions in long-term care
• Willing to assist with planning, organizing, implementing, and interpreting programs, goals, objectives, policies, and procedures of clinical services

Essential Functions

• Able to read, write, speak, and understand the English language
• Practice dependable, regular attendance
• Concentrate and use reasoning skills and good judgment
• Communicate and function in an interdisciplinary team
• Able to sit, stand, bend, lift, push, pull, stoop, walk, and move intermittently during working hours
• Understand and follow company policies, including harassment and complaint procedures

Benefits for Full-Time Associates

• medical, dental, vision coverage
• 401(k)
• paid vacation, sick days and holidays

An Equal Opportunity Employer

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Standard shift:

• Day shift

Weekly schedule:

• Monday to Friday

Experience:

• medical billing: 3 years (Preferred)

License/Certification:

• RN license (Preferred)

Work Location: On the road

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