CareOne
Responsibilities
Monitor compliance with the Monthly Billing Reconciliation process
Audit the completion and accuracy of MDS's and Care Plans per schedule as required for Medicare, Managed Care and OBRA schedules
Ensure compliance with State, Federal, and SimpleLTC transmissions and facilitate modifications as needed
Facilitate and coordinate with other regional staff as needed
Communicate promptly to your supervisor and facility team/regional team any issues or concerns
Monitor/Audit the issuance of denial letters, coordination of Medicare certification completion, and nursing documentation to support skilled needs
Serve as a resource for the center staff for PDPM and state Medicaid reimbursement guidelines
Monitor the compliance of company processes developed to appropriately maximize reimbursement
Qualifications
Passing RAC-CT certification course within 90 days of employment (paid for by CareOne)
2-4 Years' prior experience in Medicare PDPM Reimbursement and/or MDS experience
General knowledge of Managed Care reimbursement systems
Excellent ability to work collaboratively with a cross‑functional healthcare team
Basic knowledge of Quality Measures
Knowledge of the 5 Star report
About Us The CareOne mission is to define excellence within the health care community. We are dedicated to maximizing patient outcomes and treat residents, their families, and each other with respect, dignity, and compassion. Through a collaborative and consultative approach, we strive to provide a framework of strength and stability for our centers and communities. We work to maintain the highest standards of care and service for residents, families and our valued employees.
Benefits
Comprehensive healthcare benefits
Multiple medical plans
Including pharmacy
Including Teladoc
Multiple dental plans
Vision plan
Health savings account (eligibility restrictions apply)
Flexible spending accounts
Voluntary life and AD&D
Short‑term and long‑term disability plans
Hospital indemnity insurance
Critical illness insurance
Accident insurance
Whole life insurance
Medicare employee assistance
Legal plan
Commuter benefits
401k retirement plan
Employee assistance program (available to all employees)
Paid time off
Vacation
Sick plans in accordance with state laws
Opportunities to advance and grow your career
Equal Opportunity Employment We are an Equal Opportunity Employer. EEO/AA/M/F/DV
#J-18808-Ljbffr
Monitor compliance with the Monthly Billing Reconciliation process
Audit the completion and accuracy of MDS's and Care Plans per schedule as required for Medicare, Managed Care and OBRA schedules
Ensure compliance with State, Federal, and SimpleLTC transmissions and facilitate modifications as needed
Facilitate and coordinate with other regional staff as needed
Communicate promptly to your supervisor and facility team/regional team any issues or concerns
Monitor/Audit the issuance of denial letters, coordination of Medicare certification completion, and nursing documentation to support skilled needs
Serve as a resource for the center staff for PDPM and state Medicaid reimbursement guidelines
Monitor the compliance of company processes developed to appropriately maximize reimbursement
Qualifications
Passing RAC-CT certification course within 90 days of employment (paid for by CareOne)
2-4 Years' prior experience in Medicare PDPM Reimbursement and/or MDS experience
General knowledge of Managed Care reimbursement systems
Excellent ability to work collaboratively with a cross‑functional healthcare team
Basic knowledge of Quality Measures
Knowledge of the 5 Star report
About Us The CareOne mission is to define excellence within the health care community. We are dedicated to maximizing patient outcomes and treat residents, their families, and each other with respect, dignity, and compassion. Through a collaborative and consultative approach, we strive to provide a framework of strength and stability for our centers and communities. We work to maintain the highest standards of care and service for residents, families and our valued employees.
Benefits
Comprehensive healthcare benefits
Multiple medical plans
Including pharmacy
Including Teladoc
Multiple dental plans
Vision plan
Health savings account (eligibility restrictions apply)
Flexible spending accounts
Voluntary life and AD&D
Short‑term and long‑term disability plans
Hospital indemnity insurance
Critical illness insurance
Accident insurance
Whole life insurance
Medicare employee assistance
Legal plan
Commuter benefits
401k retirement plan
Employee assistance program (available to all employees)
Paid time off
Vacation
Sick plans in accordance with state laws
Opportunities to advance and grow your career
Equal Opportunity Employment We are an Equal Opportunity Employer. EEO/AA/M/F/DV
#J-18808-Ljbffr