Joanne Montanez
Plainville,CT
Summary
Licensed Practical Nurse (LPN) | RAC-CT | Clinical Reimbursement & MDS Coordinator with over 13 years of nursing experience and nearly 20 years in healthcare, specializing in long-term care, skilled nursing, Medicare reimbursement, and regulatory compliance. Extensive experience leading the MDS process, coordinating interdisciplinary teams, optimizing PDPM reimbursement, and ensuring CMS compliance. Proven ability to improve documentation accuracy, manage Medicare and Managed Care authorizations, and collaborate with clinical, therapy, and billing departments to maximize reimbursement while maintaining exceptional resident care.
Overview
1
1
Certification
19
19
years of professional experience
Work History
MDS Coordinator
CT Baptist Homes
02.2025 - Current
- Coordinate all MDS 3.0 assessments, including Admission, Quarterly, Annual, Significant Change, IPA, and PPS assessments.
- Manage Assessment Reference Dates (ARDs) to ensure CMS compliance and optimize PDPM reimbursement.
- Review clinical documentation for accurate coding and reimbursement.
- Submit MDS assessments through CMS while resolving validation errors.
- Collaborate with nursing, rehabilitation, physicians, dietary, social services, activities, and billing departments.
- Participate in Medicare meetings and interdisciplinary care plan meetings.
- Monitor Quality Measures and identify opportunities for quality improvement.
- Educate nursing staff on documentation requirements and MDS regulations.
- 60-bed Skilled Nursing Facility
Charge Nurse
Southington Care Center
11.2022 - 02.2025
- Administered medications and treatments according to physician orders.
- Completed resident assessments and change-in-condition evaluations.
- Performed wound care and blood glucose monitoring.
- Supervised Certified Nursing Assistants.
- Communicated changes in resident condition with providers and nursing leadership.
- Maintained accurate clinical documentation.
- Managed 15 patients on Short-Term Rehab and up to 30 residents Long-Term Care
MDS Director
Waterbury Center for Nursing & Rehabilitation
08.2022 - 01.2025
- Directed all MDS operations for a 120-bed skilled nursing facility.
- Oversaw timely completion of all OBRA and Medicare assessments.
- Coordinated interdisciplinary scheduling and Assessment Reference Dates.
- Managed authorizations and insurance clinical updates for Managed Medicare.
- Issued Notices of Medicare Non-Coverage (NOMNCs) and Advance Beneficiary Notices (ABNs).
- Verified ICD-10 coding accuracy for optimal reimbursement.
- Collaborated with therapy, physicians, admissions, billing, and administration.
- Maintained CMS compliance while maximizing reimbursement opportunities.
- 120-bed Skilled Nursing & Rehabilitation Facility
MDS Coordinator / Assistant Unit Manager (SACU Rehab)
Avery Heights
01.2019 - 01.2022
- Coordinated MDS assessments for short-term rehabilitation residents.
- Developed individualized care plans with interdisciplinary team members.
- Collaborated with physicians and rehabilitation staff regarding resident progress.
- Coordinated discharge planning and family education.
- Ensured Medicare and regulatory compliance.
- 200-bed Skilled Nursing & Rehabilitation Facility
LPN • Resource Nurse • Assistant MDS Coordinator
Avery Heights
01.2014 - 01.2019
- Administered medications and treatments.
- Performed resident assessments and supervised nursing assistants.
- Assisted with MDS scheduling and completion.
- Reviewed ICD-10 diagnoses for reimbursement accuracy.
- Utilized MatrixCare, Epic, and Allscripts.
- Coordinated transportation, appointments, staffing assignments, and discharge documentation.
- Mentored nursing students.
Licensed Practical Nurse
Park Place Health Center
01.2013 - 01.2015
- Administered medications and treatments according to physician protocols and established guidelines.
- Conducted regular assessments of patient needs, adjusting care strategies to optimize outcomes.
- Demonstrated excellent technical skills in wound dressing changes, IV therapy administration, catheter insertion, and other routine nursing procedures.
- Managed time-sensitive tasks effectively under pressure while maintaining composure during critical situations or emergencies.
- Managed 30+ residents on long-term care units
Certified Nursing Assistant
Avery Heights
01.2008 - 01.2013
- Assisted residents with activities of daily living.
- Operated Hoyer and Sara lifts.
- Documented intake and output.
- Maintained resident safety and comfort.
- Supported the needs of 10+ residents under long-term care.
Account Analyst
Connecticut Surgical Group
01.2010 - 01.2012
- Managed client communications, ensuring prompt resolution of inquiries and fostering long-term relationships.
- Processed and coded medical claims for accurate billing and reimbursement.
- Reviewed patient records to ensure compliance with insurance guidelines.
- Implemented coding updates in accordance with regulatory changes and standards.
- Collaborated with healthcare providers to resolve billing discrepancies efficiently.
- Trained new staff on coding procedures and billing software usage.
- Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
Accounts Receivable Specialist
Connecticut Multispecialty Group
10.2008 - 12.2010
- Insurance verification
- Commercial insurance collections
- Employee software training
- Analyzed medical records for accurate coding and compliance with regulations.
- Collaborated with healthcare providers to clarify documentation requirements for optimal coding.
- Led audits of coded claims, identifying trends and recommending corrective actions to management.
- Reduced claim denials by maintaining thorough knowledge of payer-specific requirements and guidelines.
- Reduced turnaround time for appeals by preparing comprehensive supporting documentation for denied claims.
Education
Licensed Practical Nurse Program -
Lincoln Technical Institute
New Britain, CT03.2013
Medical Billing & Coding -
Fox Institute of Business
West Hartford, CT10.2008
Certified Nursing Assistant Program -
YMCA of New Britain
New Britain, CT06.2006
Skills
- MDS 30 (OBRA & PPS)
- PDPM Reimbursement
- Medicare Part A & Managed Medicare
- Medicaid CMI
- Assessment Reference Date (ARD) Management
- Clinical Reimbursement
- Care Area Assessments (CAAs)
- Care Planning
- ICD-10 Coding
- Medicare ABNs & NOMNCs
- Managed Care Clinical Updates
- CMS Submission & Validation Reports
- Quality Measures (QMs)
- Regulatory Compliance
- MatrixCare
- Epic
- Point Click Care
- Documentation accuracy
- Audit preparation
Certification
- RAC-CT (Resident Assessment Coordinator–Certified)
- Licensed Practical Nurse (LPN)
- CPR Certified
Timeline
MDS Coordinator
CT Baptist Homes
02.2025 - Current
Charge Nurse
Southington Care Center
11.2022 - 02.2025
MDS Director
Waterbury Center for Nursing & Rehabilitation
08.2022 - 01.2025
MDS Coordinator / Assistant Unit Manager (SACU Rehab)
Avery Heights
01.2019 - 01.2022
LPN • Resource Nurse • Assistant MDS Coordinator
Avery Heights
01.2014 - 01.2019
Licensed Practical Nurse
Park Place Health Center
01.2013 - 01.2015
Account Analyst
Connecticut Surgical Group
01.2010 - 01.2012
Accounts Receivable Specialist
Connecticut Multispecialty Group
10.2008 - 12.2010
Certified Nursing Assistant
Avery Heights
01.2008 - 01.2013
Licensed Practical Nurse Program -
Lincoln Technical Institute
Medical Billing & Coding -
Fox Institute of Business
Certified Nursing Assistant Program -
YMCA of New Britain