Laurus Healthcare is currently seeking a Lead RNAC for a highly regarded Not-for-Profit Senior Living Organization in the greater Philadelphia area.
- Manages the Medicare/Medicaid reimbursement process including auditing prior to submission.
- Acts as primary lead source for training and development of RNAC team.
- Participates in the development, implementation and ongoing evaluation of reimbursement priorities and reviews outcomes regularly.
- Evaluates the Medicare and Medicaid processes on a monthly basis.
- Allows for proper utilization of services to capture appropriate reimbursement.
- Participates in Medicare meetings to review issues and requirements.
- Communicates regularly with the leadership of the facility.
- Collaborates with Finance/Reimbursement Services to review reports.
- Responsible for providing ongoing communication of findings to administration of the status and effect of clinical documentation on the RAI process.
- Analyzes case mix and management through identifying, evaluating and explaining variations to the Administrator and Director of Nursing.
- Ensures compliance with CMS and Pennsylvania reimbursement regulations.
- Provides reports and supporting documentation to DOH and other regulatory agencies.