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Minimum Data Set Nurse RN

Company: Myrtle Beach Manor
Location: Myrtle Beach
Posted on: March 21, 2023

Job Description:

Description: Myrtle Beach Manor is seeking a MDS Coordinator (RN)FUNCTION: Overall case management of the facility Medicare/Managed Care Program. QUALIFICATIONS: The requirements listed below are representative of the knowledge, skill and/or ability required.Requirements are representative of minimum levels of knowledge, skills and/or abilities. To perform this job successfully, incumbent will possess the mental abilities or aptitudes to perform each duty proficiently.All requirements are subject to possible modification to reasonably accommodate individuals with disabilities.Minimum Qualifications:-- Freedom from illegal use of drugs.-- Freedom from use of and effects of use of drugs and alcohol in the workplace.-- Anyone found guilty by a court of law of abusing, neglecting or mistreating individuals in a health care related setting are ineligible for employment in the position.-- Demonstrates effective time management skills.-- Ability to communicate verbally with an excellent comprehension of the English language. Education and/or Experience: A registered nurse with health care experience in a skilled nursing facility, with a focus on Medicare/Managed care programs. Computer experience in EHR required. ICD10- coding knowledge preferred. The Medicare Coordinator activities in limited circumstances may be carried out by an LPN/LVN under the direction/supervision of an RN. Certificates, Licenses, Registrations: Current unrestricted state license to practice as a Registered Nurse. Current CPR certification and additional certification in nursing specialty desired. AANAC Medicare University Credentialing preferred.LANGUAGE SKILLS: Ability to read, analyze and interpret Medicare regulations and guidance, professional journals, technical procedures, or other governmental regulations. Ability to write reports, nursing/resident progress notes and nursing procedures. Ability to effectively present information and respond to questions from interdisciplinary team members, customers (Residents, family members, physicians, etc.) and the general public. MATHEMATICAL SKILLS: Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw conclusions and interpret data.REASONING ABILITY: Ability to solve practical problems and deal with a variety of concrete variables. Ability to interpret a variety of instructions furnished in electronic, written, oral, diagram or schedule form.INTERPERSONAL SKILLS: Demonstrates active listening techniques, gains support through effective relationships, treats others with dignity and respect, seeks feedback, sets clear standards for performance, evaluates job performance, and provides effective feedback, establishes system to measure effectiveness, efficiency and service and creates and maintains reporting mechanisms.ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: To perform this job successfully, an individual must be able to perform each key function satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the key functions.Resident Rights: Promotes and protects resident's rights, assists residents to make informed decisions, treats residents with dignity and respect, protects residents' personal belongings, reports suspected abuse or neglect, avoids the need for physical restraints in accordance with current professional standards and supports independent expression, choice and decision-making consistent with applicable law and regulation.Leadership: Demonstrates willingness to try new tasks, generates new ideas for change, evaluates and recognizes priorities, select effective team members, challenges others to learn, keeps current and integrates new information, communicates, and models organization values, fosters high performance, recognizes need for and provides adequate resources.Process Improvement: Applies process improvement methods and techniques and identifies processes for improvement in daily work.Environment of Care: Demonstrates understanding of fire and emergency procedures, participates in fire and disaster drills, demonstrates understanding of safety and security procedures, applies safety and security precautions, demonstrates understanding the hazardous materials plan and demonstrates proper use of equipment.Infection Control/Prevention: Applies hand washing principles during daily work, demonstrates understanding of isolation precautions, recognizes signs and symptoms of infection and complies with the employee health program, demonstrates understanding the process of identifying and handling infectious waste, maintains personal hygiene, complies with OSHA standards in the workplace and demonstrates understanding of cross-contamination.Information Management: Enters or records data timely and accurately, protects confidentiality of resident information, protects data against loss or destruction, logs onto the system using own password, logs off the system when leaving the workstation, reports suspected violation of security/confidentiality issues, reviews data and identifies trends and deletes passwords of employees no longer needing access to software programs.CONTINUING EDUCATION: Attends in-service and education programs and attends and completes continuing education required for maintenance of professional certification or licensure. Develop and maintain professional affiliations. PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable the individuals with disabilities to perform the essential functions.While performing the duties of this job, the employee is frequently required to stand, walk, use hands or fingers, reach with hands and arms, talk, or hear. The employee is occasionally required to sit, climb, or balance and stoop or kneel. The employee on occasion will assist to lift and/or transfer Residents weighing between 100 to 250 pounds. Specific vision abilities required by this job include close vision, distant vision, and peripheral vision.Must be able to move intermittently throughout the workday. Ability to sit and stand for extended periods of time. Must be able to cope with mental and emotional stress of the position.Must possess sight and hearing senses or use a prosthesis that will enable these senses to function adequately, so that the requirements of this position can be fully met.Must function independently, have flexibility, personal integrity, and the ability to work effectively with residents, personnel, and support staff/agencies.Ability to see with reasonable acuity and appropriate accommodation, full field of vision and be able to distinguish depth. Ability to move about with reasonable accommodation, reach, turn, twist, touch, and bend. Ability to hear normal noise levels with accommodation and tolerate occasional loud noises.WORK ENVIRONMENT: The work environment characteristics described are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Works in well-lighted/ventilated office and therapy areas.Subject to frequent interruptions.Involved with residents, family members, personnel, etc., under all conditions/circumstances.Subject to hostile and emotionally upset residents, family members, etc.Communicates with corporate staff and facility staff.Willingness to work beyond normal working hours and in other positions temporarily when necessary.Attend and participate in continuing education programs.May be subject to fall, burns from equipment, infectious disease, odors, etc. throughout the workday.May be subject to lifting, carrying, and supporting residents.While performing the duties of this job, the employee is occasionally exposed to blood or other body fluids, fumes, airborne particles and toxic or caustic chemicals. The noise level in the work environment is usually moderate.Requirements:Roles and Responsibilities:-- Participates in pre-admission screening process to validate Medicare/Managed care requirements and prepare for the patient driven care needs of each potential new admission.-- Reviews the ICD-10 Coding and sequencing on the UB04, MDS and in the Medical Record to validate the primary diagnosis and each secondary diagnosis that impact the patient care are accurately documented-- Track Medicare physician certifications for timeliness, accuracy and completeness of information and signatures-- Verify an initial skilled note and a weekly skilled note is completed for all Skilled patients in accordance with policy-- Participates in daily PPS, weekly case management and monthly Triple check meetings -- Validate that resident services provided externally to the facility are reviewed by the interdisciplinary team for consolidated billing process exclusions and to minimize unnecessary facility cost for covered services.-- Coordinates the NOMNC/ABN process, assisting with the completion and delivery of the required detail notices and responding to appeals by being the contact for the QIO and responding to documentation requests from the QIO.-- Participates in the Medicare and other insurer Medical Review and Appeals process-- Coordinates the participation in the Medicare and other insurer payment program processes-- Performs ongoing tracking of payment categories and related supportive documentation.-- Performs regular audits to monitors documentation to ensure compliance with program guidelines (physician orders, MD certifications/re-certifications, daily notes, denial documentation/letters).-- Collaborates with Business Office Manager to ensure timely and accurate billing.-- Performs other related duties as directed/assigned by the Administrator and Director of Nursing.PI208463617

Keywords: Myrtle Beach Manor, Wilmington , Minimum Data Set Nurse RN, Healthcare , Myrtle Beach, North Carolina

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