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Overview

Smile, You’ve Found Us!

Are you passionate about caregiving? Would you like to work with the best team in the world? If so, Diversicare invites you to apply.

We build on trust, respect, customer focus, compassion, diplomacy, appreciation and strong communication skills to shape the culture in our workplace. Diversicare team members play a critical role in fostering an environment of Service Excellence, which we extend to all those we are privileged to serve.

If you wish to make a difference in the lives of our patients and residents, **APPLY NOW!**

Full Time Benefits include:

+ **Medical/Dental/Vision**

+ **Excellent 401k plan**

+ **Tuition Reimbursement**

+ **Vacation, Holiday, and Sick Time**

+ **Long and Short Term Disability**

+ **Employee Assistance Program**

+ **Life Insurance**

+ **Referral Bonuses**

+ **DiversICARE - employee hardship fund**

+ **Pay advancement program - OnShift Wallet**

Diversicare provides post-acute care services to patients and residents at 46 skilled nursing and long-term care centers in five states, primarily in the Southeast, Midwest and Southwest United States. Together, with our team of dedicated healthcare professionals, we leverage our diverse strengths to provide each patient and resident with healthcare serves that best meet their needs.

It is Diversicare’s Mission to _“Improve every life we touch by providing exceptional healthcare and exceeding expectations.”_

We are guided to excellence by five Core Values: Integrity, Excellence, Compassion, Teamwork and Stewardship, as well as 12 Service Standards.

We build on trust, respect, customer focus, compassion, diplomacy, appreciation and strong communication skills to shape the culture in our workplace. Diversicare team members play a critical role in fostering an environment of Service Excellence. Our Service Standards are in place to offer support. They lead us to what matters most to our company: _creating a warm, caring, safe and professional environment for our customers and each other._

Our culture of impassioned service delivery is the _Diversicare Difference_ .

\#BSC123

Responsibilities

The key role of the Clinical Reimbursement Specialist is to ensure that the RAI process at each facility is being completed/coordinated in a timely and accurate manner that is in compliance with federal and state regulations. In addition to these responsibilities, the following expectations, which are not all-inclusive, will guide the Clinical Reimbursement Specialist:

1. Train and consult with RNACs and MDSCs on the RAI, Medicare, Medicaid and Managed Care processes to facilitate compliance, integrity and accurate reimbursement.

2. Train and consult with Center staff and Administration on the RAI, Medicare, Medicaid and Managed Care processes to facilitate compliance, integrity and accurate reimbursement.

3. Function as the subject matter expert for the regional team on the RAI, Medicare, Medicaid and Managed Care processes

4. Utilize Electronic Health Record and other available data systems to audit and monitor integrity of:

5. RUG Trends

6. ALOS

7. ADL Coding Accuracy

8. Overall RAI process

9. Identification and resolution of data integrity issues

10. Medicare, Medicaid and Managed Care program requirements

11. Medicare, Managed Care and Medicaid rates

12. Utilize Electronic Health Record and other available data systems to analyze and project Medicare, Managed Care, and Medicaid rates to facilitate accurate identification of provided services.

13. Review and analyze QM reports, investigate trends, and assist facilities in development and completion of plans to influence improvement.

14. Train and consult with centers on Medicare, Medicaid and Managed care Documentation Requests to ensure prompt response and corrective action.

15. Support Centers in retention and recruitment of MDS staff:

16. Complete second level interviews

17. Orient and provide ongoing training

18. Provide recommendations for performance assessment to administrator

19. Participate in Regional meetings and activities:

20. Quality Reviews

21. QAPI

22. Participate in Clinical Reimbursement Department Activities:

23. Program Development

24. Trainings

Qualifications

1. Current license by State Board of Nursing, RN required.

2. Minimum of 3 years of experience in clinical reimbursement in the long term care setting.

3. Prior experience in multi-facility management strong preferred.

4. Excellent communication skills; prior experience in teaching/training preferred.

5. Computer skills necessary.

6. ANNAC certification preferred.

Diversicare is committed to being an equal opportunity employer. Diversicare does not discriminate in employment opportunities or practices on the basis of race, color, religion, sex (including gender identity), national origin, age, or disability, sexual orientation, citizenship, marital status, veteran status, genetic information, or any other characteristic protected by law.

(EOE)

**Job ID** _2025-62952_

**Type** _Regular Full-Time_

**Location Name** _Diversicare Healthcare Services - Huntsville, AL_

**_Location_** _US-AL-Huntsville_