Title: Director of Clinical Assessment
Location: Eldersburg, MD
• Assisting, planning, developing and reviewing MDS related policies/procedures, programs, and tools and ensuring full and on-going, effective and accurate implementation.
• Developing and implementing programs and processes to ensure that the MDS is completed in an accurate manner and in a process consistent with maintaining all requirements, Medicare regulations and standards of professional practice.
• Performing and managing the denials management process (as part of the Recovery Audit Contractors Audit and other audits).
• Providing system-wide coding quality reviews and assessing audit denials
• Identifying audit appeal strategies and developing focused coder education and auditing programs to improve skills and compliance
• Determining documentation improvement opportunities in order to reduce and/or eliminate future reviews.
• Providing a high-level of technical competency and serving as a subject matter expert regarding documentation, coding, billing, and reimbursement, Medicare regulations, compliance and compliance management.
• Leading special compliance related projects.
• Developing and delivering educational programs, informational materials, work products and tools to departments in order to optimize data quality and appropriate payment methods, improve skills, establish improved physician documentation initiatives, respond to the perceived needs of coding quality reviews, and support the development and implementation of best practices, guidelines and policies to ensure compliance with regulations.
Desired Skills & Experience:
• 5-10 years experience as a community based MDS Coordinator
• 1-3 years experience as a regional MDS Coordinator preferred.
• BSN required, MSN preferred
• AANAC certification required, preference to those certified as a Master Trainer
• Valid licensure as an RN
Should someone need more information I can be reached at email@example.com 203-567-0144.