Clinical Reimbursement Manager
To apply: please email me at sperdue@npseniorliving.com. Please include a PDF of your resume, your salary needs, and the name of the position you are applying too.
Why New Perspective Senior Living? A career with a purpose starts here!
This is an exciting time to join New Perspective. We are a growing company serving over 4,000 seniors today with a goal of reaching 10,000. Our growth is creating energy, excitement, and the opportunity to make a difference in the lives of others. We have a culture of servant leadership and collaboration that supports each team member’s personal and professional development. At New Perspective you’re not just an employee, you are a valued member of our team.
The Clinical Reimbursement Manager (“CRM”) will serve as the subject matter expert in Medicaid waiver programs, including allowed services, documentation, and billing protocols. The CRM provides guidance, education, and support to community teams regarding appropriate Medicaid waiver services and documentation to enable accurate and timely billing for resident beneficiaries of Medicaid government assistance.
Responsibilities
As resident acuity changes, communicate/coordinate with MCO’s to support timely reassessments, service authorizations, and accurate Medicaid billing rates.
Regular case manager communication to support appropriate reimbursement within government payor protocols.
Create and maintain community beneficiary case manager communications files and case manager contact information in support of healthy working relationships.
Conduct community site visits to update resident support plans (file new, remove expired); review resident needs, issues, and concerns with on-site nursing team to enable effective up-to-date communication with case managers; and provide team member education on government reimbursement processing protocols to include allowable services.
In collaboration with the clinical and compliance teams, timely remediate identified process improvement needs to include perceived irregularities in documents necessary to support government reimbursement.
Audit, track, and trend government beneficiary reimbursement metrics for impact on quality resident services delivery and regulatory compliance with reimbursement protocols and opportunities for process improvement.
Qualifications
Licensed nurse (LPN or RN) or Licensed Social Worker strongly preferred
Experience as a Case Worker, Case Manager, or Care Coordinator preferred
Experience working with government payor case management, such as Elderly Waiver and CADI
Experience with Medicaid reimbursed services, including completion of Medicaid Rate Sheets
Detail-oriented with proficient documentation skills
Strong interpersonal and organizational skills with the ability to work independently as well as collaboratively
Proficient in working with electronic health records
Proficient in written and verbal communication
Proficient in working with Microsoft Excel and the full Microsoft Suite (Outlook, Word, PowerPoint, etc.)
Ability to travel up to 30% of the time with minimal overnight stays required
Salary
The salary range for this role is $65,000-$77,500 depending on experience and qualifications.
Team Member Benefits & Perks*
Medical, Dental, & Vision Insurance
401(k) with Company Match!
Paid Time Off and Holidays
Company-Paid Basic Life Insurance
Voluntary Short-Term Disability
Company-Paid Long-Term Disability
Health Reimbursement Account/Health Savings Account
Flexible Spending Accounts
Education assistance - up to $5,000 per calendar year!
Leadership Development & Career Advancement
Real-time Access to Earned Wages
Referral Bonuses
Employee Assistance Program
*Benefits vary by full-time, part-time, and PRN status.
New Perspective is an Equal Opportunity Employer.