Debra Rayas

Successfully execute MDS assessments remotely for multiple skilled nursing facilities across Colorado, ensuring strict adherence to evolving state and federal regulations.
• Validate Case Mix Index (CMI) accuracy to ensure resident functional statuses are precisely reflected for reimbursement.
• Conduct regular, proactive audits of MDS records, driving overall data consistency and reducing potential Medicare/Medicaid denials.
• Evaluate complex medical records to accurately assign ICD-10 codes for primary and current diagnoses.
• Collaborate with on-site interdisciplinary teams via Zoom and telephone to facilitate seamless data collection.
• Maintain rigid data security and safeguard resident privacy rights by adhering strictly to HIPAA guidelines while accessing remote EHR systems.

• Managed the end-to-end MDS assessment and care planning process for a comprehensive skilled nursing environment in full compliance with regulatory standards.
  • Reduced coding errors by developing tailored training materials and providing ongoing education to floor staff regarding documentation best practices and regulatory shifts.
  • Expedited the facility reimbursement pipeline by consistently submitting error-free MDS reports well within state and federal timelines.
  • Fostered positive, professional relationships with external surveyors and regulatory agencies through prompt, accurate responses to audit requests.
  • Facilitated multidisciplinary resident care conferences to track goal progress and dynamically adjust care plans