
Registered nurse recognized for expertise in clinical anyalysis, reimbursement, case management, and ICD-10 coding. Committed to ensuring compliance and enhancing care quality, leveraging strong analytical skills to optimize reimbursement and improve patient care while demonstrating excellent time management.
-Schedule and complete the MDS assessments in accordance with federal and state regulations ensuring accuracy and timeliness to avoid penalties or payment delays
-Demonstrate knowledge of ICD-10 coding to support optimal PDPM reimbursement
-Monitor and maintain compliance with CMS guidelines and regulations
-Serve as a liasion between nursing staff, therapy, physicians, and administrative staff to ensure continuity of care
-Analyze clinical documentation to verify that it supports coding, case mix index, and reimbursement
-Develop individualized, comprehensive care plans and conduct care plan meetings with patient, families, and IDT
-Participate in audits, Medicare/Medicaid reviews, surveys, QA, and QAPI.
-Perform comprehensive in-home assessments to evaluate patient health status and needs
-Schedule and complete OASIS assessments in according to CMS guidelines and timelines.
-Analyze clinical documentation and utilize ICD-10 coding knowledge to ensure accuracy of plan of care and reimbursement.
-Develop individualized care plans to ensure health care needs and safety are met to avoid hospitalization or negative outcome
-Coordinate and oversee all aspects of patient care including therapy services, social work, skilled nursing.
-Monitor patient progress and adjust goals and care plan based on clinical findings and physician orders.
-Educate patient and caregivers on disease process and management.
-Participate in care conferences, case reviews, and quality improvement.
-Provide direct patient care to a diverse population with acute and chronic medical conditions in a fast paced hospital setting.
-Perform comprehensive assessments and identify changes in condition to ensure timely interventions.
-Administer medications, IV therapies, blood products, and treatments in accordance to physician orders.
-Coordinate patient care to include admissions, transfers, discharges.
-Prioritize and manage care for multiple patients
-Respond to emergencies and participate in rapid response or code situations as needed