Diversity, Equity, and Inclusion are at the heart of Cantex. We are committed to a culture that respects our differences and values the contributions of all people.

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Job Summary:

The overall purpose of the Patient Care Coordinator position is to ensure appropriate reimbursement of Medicare and/or Medicaid Patients through the Patient Assessment Instrument (RAI) process. Assists in the management of quality Patient care on a continuing basis in accordance with federal and state standards and as may be directed by the Administrator or Director of Nursing.

Qualifications:

• A current, valid Texas nursing license is required (RN, LVN)
• At least 2 years of LTC experience preferred.
• Must have an Acknowledgement of Completion Certificate through the HHSC RUG Online Training for Nursing Facilities.
• Must complete the American Association of Nurse Assessment Coordinators (AANAC) RAI Certification within 1 year of employment.
• Ability to effectively communicate, direct, and at times, delegate tasks.
• Ability to read, write, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
• Ability to write reports, business correspondence, nursing/Patient progress notes, and nursing procedures.
• Ability to effectively present information and respond to questions from department heads, customers, (Patients, family members, physicians, etc.) and the public.

Essential Functions:

• Maintains compliance with all State and Federal Medicaid and/or Medicare rules, regulations, and published interpretations.
• Participates in the assessment of pre-admission paperwork to ensure Patient meets qualifying medical necessity determination.
• Attends standup meetings every weekday morning.
• Coordinates the Weekly Reimbursement Meeting with the Interdisciplinary Team Members to ensure proper Medicare and/or Medicaid reimbursement to match care delivery.
• Audit the Clinical Record to ensure appropriate documentation for actual care delivery. Educates and trains staff on documentation guidelines.
• Obtains Medicare qualifying diagnosis (es) on Medicare Part A Patients and updates diagnosis for each change in diagnosis.
• Initiates and updates the physician certifications for each Medicare Part A Patient.
• Completes all Minimum Data Set (MDS) assessments within the allotted time frame for each Medicare and/or Medicaid Patient.
• Reviews the 24-hour Nursing report to capture possible change in condition of a Patient.
• Prepares for all Medicaid audits.
• Tracks Patient benefit days, validates daily census and coordinates information with Financial Manager to ensure accurate billing.
• Achieves at least budgeted rates expectation.
• Has reviewed Cantex Continuing Care Network Continuing Care Network Clinical Policies and Procedures for Abuse Prevention and knows the employees responsibility to enforce it.
• Supports and upholds the Patient Care Management Systems as well as the Financial Management Systems.
• Responsible for assuring patient/resident safety.
• Performs other duties and/or tasks as assigned.

We are an Equal opportunity employer; We offer an excellent benefit plan to include 401K with match, CEU reimbursement, vacation, sick, holidays, medical, dental, and supplemental insurance Plans as well as a Highly competitive compensation package.