Partial Remote Healthcare Provider Payment Integrity Minimum Data Set Analyst

Job ID: Available for Members

Location: Indiana, Kentucky

Compensation: To Be Discussed

Posted: Monday, December 04, 2017

Job Category: Healthcare, Nursing

Travel Requirements: Field Travel Required

Weekly Hours: Full Time

Employer Type: Employer

Job Summary

A healthcare company has a current position open for a Partial Remote Healthcare Provider Payment Integrity Minimum Data Set Analyst.

Core Responsibilities of this position include:

  • Defining specifications in the payer system and ensuring their accuracy
  • Reviewing and responding to provider inquiries from other areas of the Service Center
  • Reviewing policies, procedures and systems to determine whether they are functioning as intended

Qualifications Include:

  • Ability to travel up to 5% of the time
  • Unencumbered license to practice nursing in the United States
  • At least 5 years SNF/Long Term Care work history
  • 3 years MDS 3.0 experience with 1 year PPS scheduling experience
  • Demonstrated knowledge of SNF PPS coverage criteria, Medicare Replacement Programs, technical requirements relating to PPS for SNF and effective clinical documentation practices
  • Ability to critically examine records and identify areas of potential non-compliance with the guidelines set forth in the CMS RAI/MDS 3.0 Manual