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