What are the responsibilities and job description for the Regional Clinical Reimbursement Specialist position at Alliance Health & Human Services?
Alliance Health Management Services is looking for an experienced clinical reimbursement specialist to join our regional team. In this role you will support our 8 facilities with any and all clinical reimbursement needs. Including:
- Review the current AHMS Clinical Reimbursement (CR) Policies and Procedures for respective area, recommend modifications.
- Determine compliance with established policy. Develop and utilize a facility reporting process to ensure facility compliance with established policies. This includes both remote monitoring and onsite audits.
- Evaluate current clinical reimbursement documentation forms and assessments to ensure facilities capture the care provided and maximize reimbursement.
- Provide CR transition training to the organization to ensure that trainees gain functional knowledge, and the organization is prepared for the transition.
- Serve as a resource to CR staff for problem solving and real time education as needed for respective area.
- Ensure that all submissions are accurate, timely, and fully compliant with current rules and regulations.
- Review and assist in all ARD requests from third party payers.
- Conduct onsite audits and reviews of entire CR process. Conduct exit review with facility staff with findings and clear objectives.
- Review and audit PASRR/NOMNC submissions.
- Assist facilities with QM ratings objectives.
We are a not-for-profit organization and we welcome your experience, skills, and professionalism as we improve the lives or our ressidents.
Benefits:
· 401(k)
· 401(k) matching
· Dental insurance
· Health insurance
· Life insurance
· Paid time off
· Professional development assistance
· Referral program
· Tuition reimbursement
· Vision insurance
- Employee Assistance Program
- Travel Expenses
Requirements:
2 Years expereince
Bachelor Degree Required
RN License Required
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