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MDS/PPS Coordinator

Company: Bedrock Rehabilitation and Nursing Center at Melbo
Location: Melbourne
Posted on: November 24, 2022

Job Description:

Bedrock Rehabilitation and Nursing Center at Melbourne - JOB DESCRIPTION
The MDS Coordinator is responsible for the timely completion of all OBRA and Medicare assessments to comply with federal regulations. Oversees the overall process and tracking of Prospective Payment System (PPS) Minimum Data Set (MDS) assessments including completion, submission and correction as needed. Integrates nursing, dietitian, therapeutic recreation, restorative, rehabilitation, and physician services to ensure accurate assessments which capture all clinical conditions and provided services.


  • Confirms payer source of all residents per HIQA. - -
  • Ensures the accurate and timely completion of all MDS Assessments including OBRA and Medicare PPS.
  • Maintains an accurate schedule of all MDS assessments to include the proper reference dates throughout the resident's stay.
  • Responsible for electronic submission of all MDS assessments. Verifies electronic submission of MDS and performs corrections when necessary and maintains appropriate records. -
  • Coordinates interdisciplinary participation in completing the MDS for each resident according to regulatory time frames. - Ensures completeness of MDS and thoroughness of documentation as mandated by federal and state standards.
  • Schedules resident care conferences in compliance with state and federal regulations and ensures completion of all MDS reviews prior to resident care conference. -
  • Assists disciplines with care planning process by ensuring the MDS information is completed timely, the Care Area Assessments (CAAs) are analyzed thoroughly, and the team has completed the MDS prior to care conference.
  • Ensures all Medicare documentation follows federal and state guidelines and is completed timely. This includes the physician certification/Recertification, Traditional Medicare and Medicare Advantage non-coverage letters for part A and B.
  • Monitors activities of daily living for accuracy and provides education when warranted.
  • Conducts daily PPS meeting, weekly Medicare/Insurance and Quarterly Clinical Review meetings.
  • Coordinates the monthly billing process including the triple check meeting, the attested billing report, and the HMO log.
  • Assists with the appeal process to insure that timelines are met and appeals submitted.
  • Coordinates managed care process including submitting timely updates and obtaining ongoing authorizations.
  • Ensures the timely completion of Medicaid Picture Date submissions.

    Quality Assurance of the MDS Process

  • Assess and evaluates the outcomes of the RAI process to determine additional training, education and monitoring needs.
  • Validates that the documentation supports MDS coding.
  • Conducts regular audits of the RAI process.
  • Implements all required forms, procedures and processes relative to job responsibilities.
  • Participates in the facility Quality Assurance process.
  • Assists in the development and implementation of related medical record documentation.

    Revenue Considerations

  • Tracks skilled residents to determine continued and appropriate level of care eligibility.
  • Participates in review of the pre-admission intake information to predict RUGs levels.
  • Communicates with interdisciplinary team any changes in care levels.
  • Collaborates with the RAI Specialist(s) and the Interdisciplinary team to identify and capture opportunities to assist residents in reaching their optimal physical and psychosocial levels. -
  • Maintains communication with the Billing department to facilitate accurate and timely billing.
  • Follows state specific Medicaid Case-Mix Reimbursement guidelines per regulations.

    Education and Training

  • Identifies and assists with ongoing education to staff to ensure accurate, timely, and appropriate documentation of resident services and care levels.
  • Maintains current knowledge of MDS, PPS, Medicare and Case Mix guidelines.
  • Attends and participates in continuing education programs related to industry and regulatory changes.

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    Stop your job search and apply today. If you have any questions, please call me at -321-837-9256 and look for Jessmar or send me an email at jmaca@bedrockcare.com
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    We love referrals so please share our job with friends and connections.
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    We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.
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Keywords: Bedrock Rehabilitation and Nursing Center at Melbo, Melbourne , MDS/PPS Coordinator, Other , Melbourne, Florida

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