Actuarial Fellow jobs in Wisconsin

Our skilled nursing team is looking for an MDS Coordinator!

Odd Fellow Rebekah Home Association is a non-profit skilled nursing facility just south of downtown Green Bay. We have been providing care since 1889.

Role and Responsibilities

The MDS Coordinator shall possess strong assessment skills and is responsible for completing the nursing portion of the MDS. She/He must ensure that all other departments complete their portion of the MDS timely and in accordance with State and Federal regulations. The MDS Coordinator assures the management and coordination of the Medicare, Managed care, and Medicaid reimbursement systems. This role is responsible for regulatory compliance and quality improvement efforts in order to attain the highest appropriate Medicare/Medicaid reimbursement possible for the care provided. At least 50% of your time will be spent on the clinical unit.

Essential Duties and Responsibilities:

• Oversees coordination and completion of the MDS
• Coordinates with all other departments, including Rehabilitation, Social Services, Activities, and Dietary, for documentation and timely completion of the MDS
• Provide ongoing education for employees involved in MDS documentation
• Select and set ARD’s strategically to remain compliant and accurately capture resources and reimbursement.
• Maintain and disseminate accurate and up to date records of dates to the IDT team (ARD’s, interview due dates, CAA’s due dates, MDS completion due dates, etc.)
• Accountable for accurate and timely transmission
• Facilitate Medicare meeting to monitor skilling criteria, RUG’s for accurate reimbursement, ARD selection, and D/C planning
• Accurately know the residents and skilled documentation necessary for maximum reimbursement.
• Educate Nursing staff on necessary documentation for each resident.
• Represent nursing in the resident care conference meeting
• Implement and direct Medicare and Medicaid auditing and systems review by using the Triple Check system
• Admission documentation requirements to include essential diagnosis, beginning of discharge plan, and referral for Social Services.
• Financial documentation requirements
• Obtain physician recertification
• Work closely with the ICD 10 coders for accurate diagnosis codes to include daily updates.
• Clinical documentation: skilled services, CAA’s/care plans, current diagnosis, CNA ADL’s, etc.
• Strategic selection of assessment reference date
• ADL score tracking
• Denials management, recerts, and insurance updates
• RUGs management and CMI
• MDS and PPS training
• Engage facility management team in problem solving process to identify improvement opportunities.
• Perform triple check (#11)
• Attend and participate in mandatory meetings, in-services and trainings
• Observe infection control procedures in your department
• Deal tactfully with personnel, residents, visitors, and the general public.
• Perform other related duties as requested by the Director of Nurses
• In case of emergency, will assist resident to safety
• Knowledge of regulatory standards and compliance requirements
• Able to supervise, instruct, and motivate others
• Strong organizational skills
• Able to function independently
• Leadership skills

INTERPERSONAL SKILLS:

• Demonstrates active listening skills
• Gains support through effective relationship building
• Treats others with dignity and respect
• Seeks feedback
• Sets clear standards for performance
• Establishes systems to measure effectiveness, efficiency, and service

Qualifications and Education Requirements

• Graduate of an accredited school of Nursing
• Prior experience in long-term care preferred
• Valid, current RN license
• MDS 3.0 certification preferred

Job Type: Full-time

Pay: From $80,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Medical specialties:

• Geriatrics

Physical setting:

• Long term care
• Nursing home
• Skilled nursing facility

Standard shift:

• Day shift

Supplemental schedule:

• On call

Weekly schedule:

• Monday to Friday

Work Location: In person