Keswick
Overview
Clinical Reimbursement Manager role at Keswick, Baltimore, MD. Base pay range $96,600 – $114,400. Need RN licensed in MD. Focus on managing MDS, coding, billing, audits. Work in long‑term care.
Responsibilities
Oversee clinical reimbursement operations and ensure collection of MDS information.
Complete MDS for admission, quarterly, interrupted stay, change of condition, ensuring timely coding.
Identify coding that reflects full patient condition and captures ancillary and rehab conditions.
Ensure documentation meets Keswick, regulatory agencies, supports reimbursement.
Facilitate managed care authorizations post‑admission, review contracts, seek carve‑outs.
Participate in triple‑check process with administration, rehab, business office.
Meet with rehabilitation director to ensure documentation compliance.
Identify recurring problems and communicate for resolution.
Support state/federal surveys as needed.
Track MDS schedules (timeframes and due dates).
Analyze CASPER for clinical outcome improvement, develop action plans with interdisciplinary team.
Implement strategies to optimize CMI and clinical indicators.
Prepare quality assurance reports and analyze data.
Ensure timeliness of external audits (Telligen, pre/post payment reviews), 3871s, Continued Stay Reviews.
Participate as on‑duty weekend rotation, support mission, vision, values.
Qualifications
Registered nurse, licensed and in good standing with Maryland Board of Nursing.
Experience with MDS required.
Knowledge of Resident Assessment Instrument manual, nursing, rehabilitation practice, long‑term care laws, reimbursement requirements, ICD‑10, rehabilitation coding, documentation principles.
Skill in using MDS program, PointClickCare, Microsoft Office, communication with care providers, effective listening, problem solving, working with elderly, ill, disabled consumers with sensitivity.
Benefits
Health and prescription coverage with lower‑average deductibles and copays.
Dental and vision benefits.
Free short‑ and long‑term disability coverage.
Employer paid Life and AD&D for full‑time employees (optional supplemental life insurance).
401(k) program with employer matching up to 6%.
Generous vacation, sick, holiday pay with option to “cash out” unused vacation hours.
MTA discounted bus passes.
Teladoc – free 24‑hour access to a physician.
Employee Assistance Program with free services.
Employee Recognition Program.
Free access to Employee Wellness Program (Zumba, Pilates).
Keswick is an Equal Opportunity Employer. Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Finance and Sales
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Responsibilities
Oversee clinical reimbursement operations and ensure collection of MDS information.
Complete MDS for admission, quarterly, interrupted stay, change of condition, ensuring timely coding.
Identify coding that reflects full patient condition and captures ancillary and rehab conditions.
Ensure documentation meets Keswick, regulatory agencies, supports reimbursement.
Facilitate managed care authorizations post‑admission, review contracts, seek carve‑outs.
Participate in triple‑check process with administration, rehab, business office.
Meet with rehabilitation director to ensure documentation compliance.
Identify recurring problems and communicate for resolution.
Support state/federal surveys as needed.
Track MDS schedules (timeframes and due dates).
Analyze CASPER for clinical outcome improvement, develop action plans with interdisciplinary team.
Implement strategies to optimize CMI and clinical indicators.
Prepare quality assurance reports and analyze data.
Ensure timeliness of external audits (Telligen, pre/post payment reviews), 3871s, Continued Stay Reviews.
Participate as on‑duty weekend rotation, support mission, vision, values.
Qualifications
Registered nurse, licensed and in good standing with Maryland Board of Nursing.
Experience with MDS required.
Knowledge of Resident Assessment Instrument manual, nursing, rehabilitation practice, long‑term care laws, reimbursement requirements, ICD‑10, rehabilitation coding, documentation principles.
Skill in using MDS program, PointClickCare, Microsoft Office, communication with care providers, effective listening, problem solving, working with elderly, ill, disabled consumers with sensitivity.
Benefits
Health and prescription coverage with lower‑average deductibles and copays.
Dental and vision benefits.
Free short‑ and long‑term disability coverage.
Employer paid Life and AD&D for full‑time employees (optional supplemental life insurance).
401(k) program with employer matching up to 6%.
Generous vacation, sick, holiday pay with option to “cash out” unused vacation hours.
MTA discounted bus passes.
Teladoc – free 24‑hour access to a physician.
Employee Assistance Program with free services.
Employee Recognition Program.
Free access to Employee Wellness Program (Zumba, Pilates).
Keswick is an Equal Opportunity Employer. Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Finance and Sales
#J-18808-Ljbffr