MMQ Nurse

Welcome to Genesis HealthCare! We're setting the standard for clinical excellence and responsiveness in meeting the unique needs of every resident and patient in our care. We're focused on becoming the recognized leader in clinical quality and customer satisfaction in every market we serve.POSITION SUMMARY:
Responsible for the accurate and timely completion of all Medicaid case mix documents in order to assure appropriate reimbursement for services provided within the Center. Conducts concurrent documentation review to assure achievement of maximum allowable reimbursement category.RESPONSIBILITIES /ACCOUNT ABILITIES:
Tracks customers to determine Medicaid eligibility

Reviews clinical documentation to identify potential obstacles for achieving maximum reimbursement and reports to the Director of Nursing

Communicates with the nursing team regarding the requirements for documentation and provides training as needed.

Completes admission and conversion MMQs in a timely manner.

Completes Bi Annual MMQTD

Completes Corporate Mock MMQTD every other month

Responsible for the data entry into PCC, assuring accurate data, appropriate process and timely submission of MMQTD to DMA.

Verifies corrections are accurate and accuracy of the MMQ prior to submission to DMA.

Notifies Billing office of MMQs completed and accepted for MMQTD, conversion and admissions.

Serves as the Center resource for Medicaid coverage.

Provides education to the nursing team as needed

Trains backup personnel for the completion of MMQs

Identifies areas of educational need to Center administration and regional personnel.

Maintains all reports and records of transmitted data in a systematic format and stores in a safe and locked area per HIPPA guidelines.

Implements all required forms, procedures and processes relative to job responsibilities

Utilizes all reports on PCC to monitor completion of Licensed Nursing Summaries and center acuity.

Performs other related duties as requested.Job Requirements
SPECIFIC EDUCATIONAL REQUIREMENTS:
Graduate of an accredited School of Nursing with a current RN or LPN licensure in the state in which employment occurs is required.

Experience with MMQ completion, reimbursement, clinical resource utilization is highly desirable.
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