• MDS Coordinator

    Posted: 01/22/2023

    Description

    Responsible for the coordination of the Resident Assessment Instrument (RAI) process to ensure accurate and timely completion of resident assessments, in accordance with Medicare, Medicaid, OBRA and other payer program requirements. Ensures MDS assessments accurately reflect the physical, mental and psychosocial status of each resident; ensures appropriate documentation to support services provided.

     

    Responsibilities

    • Have a thorough understanding of all regulations and standards related to the RAI process (Federal/State regulations and MDS RAI User Manual).
    • Participate in the pre-admission process to ensure essential information needed for MDS/Case Mix coding is obtained from the referral source(s) and meets Medicaid eligibility requirements when applicable.
    • Work in collaboration with the Director of Nursing to ensure necessary nursing documentation and risk assessments are completed in order to code nursing services delivered on the MDS.
    • Participate in meetings per policy.
    • Participate in the preparation and timely submission of any Additional Documentation Requests (ADRs)/ external revenue audits.
    • Participate in the community orientation to assist with education related to the RAI process.
    • Participate in the training of new associates on the RAI process.
    • Provide ongoing training/education to staff regarding RAI process to included but not limited to: ADL training, interview techniques, skilled services and documentation guidelines.
    • Demonstrate an understanding and assisting in the preparation of clinical, quality and reimbursement reports.
    • Participating in the review of quarterly Medicaid reports.
    • Completion of the RAI process.
    • Ensures timely, accurate, and complete assessment of the residents’ health and functional status during the entire assessment period.
    • Accurately code MDS to reflect services delivered per RAI guidelines. Ensures the accurate and timely completion of all MDS assessments.
    • Ensures individualized plans of care with interdisciplinary approach in accordance with federal, state and local regulations and the established policies and procedures of LLC.
    • Reviews the validation reports and ensures that appropriate follow-up action is taken.
    • Analyzes Quality Measure reports as a mechanism of quality assurance.
    • Functions as an RAI and Clinical Reimbursement resource to the community staff.
    • Attends and participates in education, such as but not limited to: webinars, meetings, RACCT, ADL training, and community training.
    • Maintains proficiency in the operations of the clinical/MDS software program.
    • Maintains proficiency in the ability to transmit data per regulatory standards.
    • Maintains confidentiality of pertinent client and employee information to assure their privacy is protected.
    • Oversee case-management of insurance utilization during skilled nursing stays.
    • Other duties as assigned.
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