MDS Coordinator - Dynamic Healthcare

The Ocean Healthcare Network, one of New Jersey’s premier seniors housing and healthcare providers, has a rare opportunity available for a Full time MDS Coordinator.

Job Summary:

To coordinate the Resident Assessment Instrument (RAI) and care planning process for all residents, inclusive of scheduling MDS assessments, completion of the MDS, review of CAT’s and completion of CAA’s.  The position is responsible for timely transmission of assessments to CMS via the IQIES system, notifying the assigned biller of the correct RUG/PDPM scores, and managing PPS schedules to maximize reimbursement.  The MDS Coordinator will plays an integral role in quality improvement related to multiple value based incentive and quality programs.  Provides training and in-servicing to staff on MDS software/system, coding rules and care planning as appropriate.

Duties and Responsibilities:

1.      Schedule assessments and tracking records for all new or readmissions, as well as existing residents per OBRA and PPS guidelines, as applicable.  Generate calendars of upcoming/due assessments and inform the IDC team to ensure timely completion of the MDS and care planning process.  Provide schedule to staff member responsible for scheduling care conferences in timely fashion.

2.      Complete “ARD Planning” as part of scheduling PPS assessments to ensure documentation is obtained as appropriate to maximize reimbursement, per RAI manual instructions.

3.      Review triggered CAT’s and CAA’s to ensure all corresponding care plans are completed.  Ensure completion of comprehensive care plan in accordance with Federal and State guidelines.

4.      Initiate/Update/Revise/Evaluate care plans as necessary when completing any OBRA assessment.  Initiate care plan reviews in MDS software corresponding to OBRA assessments.  Ensure all disciplines complete reviews and close out reviews to ensure the active care plan is part of the resident’s record. 

5.      Maintain all MDS records according to facility policy in accordance with RAI manual instructions and Federal regulations.

6.      Complete resident interviews, staff interviews as assigned; complete MDS assessments, as assigned.

7.      Track skilled residents (Medicare A, Medicare Advantage plans) benefit days.  Track any residents who have exhausted benefits, remain at a skilled level of care, and remain in the facility.

8.      Ensure timely completion of Medicare Physician Certification and Recertification forms.  Track completion of forms and ensure all pertinent information is present on the form in order for the certification/recertification to be considered valid.

9.      Transmit completed assessments to CMS via IQIES system in accordance with Federal regulations.  Maintain record of transmission through validation reports, addressing any/all messages on validation report.  Complete all tasks associated with transmission.

10.   Notify billing representative of RUG/PDPM scores once assessments have been accepted in the IQIES system.

11.   Provide billing representative with ICD10 diagnosis sheets for any skilled residents after each transmission.

12.   Actively participate in weekly Utilization meeting.

13.   Actively participate in facility QA/QI, PIP, QAPI programs.

14.   Serve as resource person and provide education to IDC team regarding quality measures. Remain abreast of value and quality based program requirements.

15.   Assist with gathering/providing documentation, as needed, for audits, appeals, additional record reviews.

16.   Provide education to IDC team members for MDS related areas.

17.   Review and respond to Reimbursement or MDS consultant’s findings.  Ensure corrections are made in software and if needed, on hard copy.