Post Acute Partners
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Job Reference #: 8577
Posted Date4 weeks ago(8/21/2019 4:18 PM)
- Requisition ID
- # of Openings
- Area of Interest
- Elderwood at Cheektowaga
- Position Type
- Regular Full-Time
Elderwood at Cheektowaga is seeking a PPS Nurse (RN) to join our clinical team!
PPS Nurse Coordinator Position Overview:
- Oversees, reviews and/or completes the MDS/PPS components of the facility based MDS/PPS departments.
- Completes and/or oversees completion of all Medicare PPS MDSs and/or OBRA assessments for both subacute and long-term care.
- Establishes the schedule for completion of the Medicare required assessments setting the completion date to maximize reimbursement and RUGs categories for each individual assessment.
- Acts as support/liaison to the business office coordinator and/or designee in determining eligibility for Medicare and tracking Medicare days in the facility.
- Serves as facility contact with Managed Care providers to ensure appropriate authorization and reimbursement for facility services provided
Essential Job Functions:
- Participates and collaborates with Medical Records and Therapy staff in preparing records for CMS and various entities for pre and post-pay record reviews, ADR requests and appeals processes.
- Manages NYS RUGs III case mix for Medicaid reimbursement.
- Completes occasional travel between facilities and Elderwood Learning Center.
- Supervises MDS Coordinator(s), if designated.
- Supports and abides by Elderwood’s and affiliate’s Mission, Vision, and Values.
- Demonstrates knowledge and understanding of all policies and procedures and ability to reference them.
- Utilizes electronic timekeeping system as directed.
- Recognizes and follows the dress code of the facility including wearing name tag at all times.
- Follows policy and procedure regarding all electronic devices, computers, tablets, etc.
- Supports and abides by Elderwood’s Mission, Vision, and Values.
- Abides by Elderwood’s businesses code of conduct, compliance and HIPAA policies.
PPS Nurse Coordinator Qualifications:
- Registered Professional Nurse with current license in state employed.
- Knowledge of MDS/PPS scheduling, completion, coding and submission requirements.
- Excellent verbal and written communication skills.
- Demonstrated knowledge of state Medicaid program, Medicare/PPS program, Managed Care programs, RUGs III and RUGs IV classification and reimbursement systems, Part A coverage guidelines and documentation requirements.
- State PRI Assessor Number preferred.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.