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Clinical Assessment Specialist (DAY SHIFT) Job Location: Wallingford Center, Connecticut

Clinical Assessment Specialist (DAY SHIFT)

40 hrs/wk Day Shift

Summary of Position:

Responsible for the coordination of the Minimum Data Set (MDS) care planning and the financial component associated with MDS.

Essential Duties and Responsibilities:

1. Implements and monitors Reimbursement Assessment Instrument (RAI) system and processes related to continuous flow of services from admission through treatment, reassessment and discharge for all patients/residents of designated care units.

2. Determines all Assessment Reference Dates (ARD) and creates/monitors MDS schedules for patients/residents based on input from other disciplines. Communicates with Interdisciplinary team daily for necessary changes in time frame.

3. Collaborates with the Interdisciplinary team s to coordinate the planning, development and implementation of a comprehensive care plan.

4. Oversees compliance with Medicare Certifications for all Medicare A / PPS patients/residents on the designated units.

5. Regularly prepares and distributes Medicare Notices for patients/residents on the designated units.

+ Communicates with Finance/Billing office regarding Medicare status and coverage as needed. Participates in monthly triple check process for all medicare claims.

+ Collaborates with the Health Information Department (HIM) to ensure appropriate documentation is submitted to government/private pay agencies in conjunction with the MDS process.

+ Maintains flexibility in work schedule/assignment to meet the needs of the Clinical Reimbursement department to include on call/weekend coverage.

+ Participates in educational programs, inservices, meetings, workshops and utilizes current literature to enhance professional skills and knowledge. Maintains current working knowledge for all changes in the RAI system and PPS.

+ Understands and follows standard infection control practices as it pertains to their department.

+ Performs other duties as assigned.

Minimum Qualifications:

Education: Graduate of school of professional nursing.

Experience: Five years clinical experience with knowledge in financial, regulatory and legal aspects of healthcare. Previous experience with MDS, care planning, clinical reimbursement including PDPM and current Medicare reimbursement processes are required.

Certificates, Licenses, Registrations: Current Connecticut State RN licensure preferred.

RAC-CT certification preferred.

Key Competencies:

Clinical knowledge of the geriatric population. Good interpersonal and communication skills. Team building skills. Self motivated, able to work independently. Strong organization skills. PC literate.

Provides care and services that demonstrate behaviors and the principles of person-centered care including affording people dignity, respect and compassion, offering coordinated care, support and treatment and care that is personalized.

This description of job responsibilities is intended to reflect the essential responsibilities and duties of the job, but is not intended to describe minor duties or other responsibilities as may be assigned from time to time.

Job ID: 14177

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