-
Director of Reimbursement
19 hours ago
Avamere Living Wilsonville, United StatesDirector of Reimbursement · Status: · Full-Time · Location: · 25115 SW Parkway Ave. Wilsonville, OR (On-site) · Compensation: · $140, $160,000.00 · Employee Perks: · Tuition assistance · Mentorship opportunities · Employee assistance program featuring free counseling services, ...
-
Director of Reimbursement
1 week ago
Avamere Living Wilsonville, United StatesDirector of Reimbursement · Status: Full-Time · Location: 25115 SW Parkway Ave. Wilsonville, OR (Hybrid) · We will consider candidates in OR and WA. You must be willing to relocate to OR/WA. Relocation assistance is available. · Employee Perks: · Tuition assistance · Mento ...
-
Director of Reimbursement
1 week ago
Avamere Living Wilsonville, United StatesDirector of Reimbursement · Status: Full-Time · Location: 25115 SW Parkway Ave. Wilsonville, OR (Hybrid) · We will consider candidates in OR and WA. You must be willing to relocate to OR/WA. Relocation assistance is available. · Employee Perks: · Tuition assistance · Mentorship ...
-
Pool Director
3 weeks ago
Diamond Ridge Day Camps Jamison, United StatesCome make a splash this summer at Diamond Ridge Camps We are looking for our next Pool Director You will be responsible for the overall safety of our campers and staff in the pool complex, educating/training our lifeguards/swim instructors on their teaching techniques for differe ...
-
Assistant Director, Finance
2 weeks ago
University of New England Portland, United StatesThe Assistant Director, Finance & Administration (ADFA) is a key member of the Health Affairs/College of Osteopathic Medicine (HA/COM) team reporting to the Director, Finance & Administration and providing financial and operational support/services to the unit.- The Assistant Dir ...
-
Director - Gary's House
1 week ago
Northern Light Mercy Hospital Portland, United States**Northern Light Mercy Hospital** · **Position is located**: Garys House, Portland, Maine · **Work Type**: Full Time \ 40 Hours per Week · **Requirements**: Bachelor's Degree · **Preferred**:Experience with development and public speaking · **Summary**: The Director has overall o ...
-
Collections Representative
1 week ago
Spurwink Services Portland, United StatesSpurwink's Finance department seeks an experienced Collections Representative to follow up on denials and outstanding accounts receivable for the agency. Including outstanding Medicare and third-party insurance and miscellaneous billing accounts older than 60 days. The Collection ...
-
Regional Office Director
3 weeks ago
State of Maine Portland, United States**REGIONAL OFFICE DIRECTOR**: · **(PUBLIC SERVICE EXECUTIVE I)**: · **_ -ANTICIPATED VACANCY-_**: · **Opening Date**: · May 06, 2024 · **Closing Date**: · May 20, 2024 · **Location**: · Portland · **Position #**: · **Position Type**: · Full Time · **Class Code**: · EA32 · **Grade ...
-
Caregiver - Bonus & Weekly Pay
1 week ago
Elite Community-Based Services Salem, United States Full timeWe're hiring Caregivers to work 1:1 patient care in Salem, AR | Offering $500.00 Loyalty Bonus, Flexible Schedules, and Weekly Pay · At Elite Community Based Services, a part of LHC Group, we embrace a culture of caring, belonging, and trust and enjoy the meaningful connections t ...
-
Technology Consulting Director
2 weeks ago
Unum Portland, United StatesWhen you join the team at Unum, you become part of an organization committed to helping you thrive. · Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensur ...
-
EHS Specialist
2 weeks ago
HP Hood Portland, United StatesAre you a self-driven person looking to advance your career as a high-impact player on a team? If so, we have an exciting challenge for you and your future · At HP Hood LLC, we celebrate our differences. Our diversity of people, backgrounds, experiences, thoughts and perspectives ...
-
Assistant Shelter Manager
2 weeks ago
MSPCA-Angell Salem, United States**This is a full time, 40 hour a week position; weekends required.** · **THE POSITION**: · We are looking for an experienced applicant for the position of Assistant Manager at our Northeast Animal Adoption Center in Salem, MA to work alongside the Shelter Manager to oversee the a ...
-
Licensing Examiner I
1 week ago
The State of New Hampshire Salem, United States**State of New Hampshire Job Posting** · **Department of Safety** · **Division of Motor Vehicles** · **154 Main Street, Salem, NH 03079 · **DMV LICENSING EXAMINER** · **(Licensing Examiner I)** · **Position #10771** · **The pay range for this position is $ $22.93 per hour · **The ...
-
HR Generalist
6 days ago
North Shore Community Health Inc Salem, United States: · **THE ORGANIZATION** · North Shore Community Health (NSCH) is a highly accomplished community health organization that prides itself on its compassionate approach to serving the surrounding communities with comprehensive and culturally sensitive care. With a strong commitment ...
-
Nursing Home Administrator
1 week ago
Avamere Health Services Wilsonville, United StatesNursing Home Administrator: · Are you an experienced Administrator looking for a new opportunity? Join us at Avamere Living and be part of a team that's dedicated to enhancing the lives of every person we serve. You'll have the opportunity to make a positive impact on the lives o ...
-
Nursing Home Administrator
2 weeks ago
Rival Inc Wilsonville, United StatesPOSITION SUMMARY · Our team is looking for a highly talented Nursing Home Administrator to assist our clients who are opening new facilities or who need temporary coverage. In this role, you'll be a full-time employee of Actriv working on-site with our clients. You'll help drive ...
-
Nursing Home Administrator
3 weeks ago
1TEST Avamere Company Wilsonville, United StatesJob Description · Job Description · Nursing Home Administrator: · Are you an experienced Administrator looking for a new opportunity? Join us at Avamere Living and be part of a team that's dedicated to enhancing the lives of every person we serve. You'll have the opportunity t ...
-
Energy Warehouse
1 week ago
ESS, Inc. Wilsonville, United StatesEnergy Warehouse (EW) Program Director / Manager Wilsonville, OR The Energy Warehouse (EW) Program Director (or Manager) will be responsible for defining and owning the execution of product strategy. This person will work closely with the entire senior leadership team (SLT) to in ...
-
Nursing Home Administrator
2 weeks ago
1TEST Avamere Company Wilsonville, United StatesJob Description · Job DescriptionNursing Home Administrator:Are you an experienced Administrator looking for a new opportunity? Join us at Avamere Living and be part of a team that's dedicated to enhancing the lives of every person we serve. You'll have the opportunity to make a ...
-
Water Distribution Technician
2 weeks ago
City of Wilsonville, OR Wilsonville, United StatesSalary: $ $37.80 HourlyLocation : Public Works - Wilsonville, ORJob Type: Full-timeJob Number: EDepartment: Public WorksOpening Date: 04/29/2024Closing Date: 5/12/2024 11:59 PM PacificPosition Overview Average amount of water you need to consume in a day - 11 to 15 cups. Average ...
Director of Reimbursement - Wilsonville, United States - Avamere Skilled Advisors, LLC
Description
Location:25117 SW Parkway Ave. Wilsonville, OR (Hybrid)
Compensation:
$140, $160,000.00
Tuition assistance
Employee assistance program featuring free counseling services, financial coaching, legal services, and more
Paid time off/sick leave (rolls over annually)
401K retirement plan with employer contributions
Comprehensive benefits package with medical coverage, voluntary dental, vision, and life insurance, short-term disability, and AD&D coverage
Avamere understands the importance of affordable and accessible healthcare for our team members and is very excited to partner with SEIU 503 and the Essential Worker Healthcare Trust to offer an excellent health insurance benefit plan at a significantly reduced cost to the employee.
Starting in 2023, our Full-Time Oregon team members will be able to participate in a PPO or HMO plan with deductibles as low as $800.00 with significantly reduced premium costs.
Employees will be eligible to start using their benefits within their first month of hire – no 60+ day waiting period Vision, Dental, STD, LTD, AD&D, and other benefits are available for enrollment as well.
The primary purpose of the Director of Reimbursement is to coordinate delivery of services to managed care and Medicare residents in collaboration with the facility's team members.
The Director of Reimbursement monitors and documents the cost effectiveness of treatment provided, facilitates and coordinates the admission and discharge process, serves as the resident and family advocate and acts as a liaison to insurance and medical management professionals.
Duties & Responsibilities:
Administrative Functions
Communicate resident status, change in function and care plan either by phone or written report to payers.
Include payer representative in interdisciplinary meetings if requested or deemed necessary to promote payer/provider relationship.
Document all payer interactions regarding resident progress, expected outcomes and reporting capabilities including special instructions.
Ensures thorough and timely communication with managed care/insurance case managers to coordinate certification and concurrent stay programs.
Maximize benefits by coordination of cost effective care, avoid fragmented care and duplication of services and ensure the appropriate level of care is provided in the most suitable setting.
Meet with facility interdisciplinary team to coordinate services to ensure that the resident's total regimen of care is maintained.Participate in all Medicare and managed care resident interdisciplinary meetings.
Work with team members to ensure discharge planning goals and objectives are developed and discussed at the interdisciplinary team meetings.
Assist in planning the services required in the resident's discharge plan as necessary.Maintain communication with facility business office and medical records to ensure accurate census and payment of managed care and Medicare residents.
Perform random charting audits to ensure accurate and thorough documentation to support reimbursement of services rendered.Meet with residents, and/or family members, as necessary. Report problem areas to department directors.
Assist with contract negotiations as necessary.
Agree not to disclose assigned user ID code and password for accessing resident/facility information and promptly report suspected or known violations of such disclosure to the Administrator.
Report any known or suspected unauthorized attempt to access facility's information system.A
dmission/Marketing Functions
Participate in the admission process including pre-admission assessment, rate negotiations, benefit verification care needs and reporting.
Assist interdisciplinary team in planning for admission and ensure staff are adequately prepared to meet needs of the managed care/Medicare resident on admission.
Greet newly admitted managed care and Medicare residents upon admission. Escort them to their rooms as necessary.Participate in marketing functions as deemed appropriate to assist with increasing managed care and Medicare census.
Charting and Documentation
Assist with completion and filing of recordkeeping forms/charts upon admission, transfer, and/or discharge of the managed care and Medicare resident.
Assist nursing staff in communication to physicians, transcription of orders, and documentation as required.Coordinate accurate and timely completion and revision of minimum data set (MDS), including the implementation of RAPs, Triggers and care plans on managed care and Medicare residents.
Complete assigned sections.Ensure that assigned residents' care plans accurately reflect appropriate goals, problems, approaches, and revisions based on resident needs.
Sign and date all entries made in the residents' medical records.
Personnel Functions
Develop and maintain a good rapport with interdepartmental personnel, as well as other departments within the facility to ensure that services can be maintained to meet the needs of the residents.
Make appropriate reports to department supervisors as required or as may be necessary. Follow facility's established procedures.Report known or suspected incidents of fraud, waste and or abuse to the Administrator.t
Ensure that departmental computer workstations left unattended are properly logged off or the password protected automatic screen-saver activates within established facility policy guidelines.
Participation in all compliance training programs.Nursing Care Functions
Ensure that appropriate supplies and equipment, etc., are available to meet the needs of assigned residents.
Participate in the orientation of new residents/family members to the facility.
Make rounds with physicians as necessary.
Assist in arranging for diagnostic and therapeutic services, as necessary.
Consult with the resident's physician in providing care, treatment, rehabilitation, etc., as necessary.
Admit, transfer, and discharge Medicare and managed care residents as required.
Budget and Planning Functions
Report suspected or known incidence of fraud relative to false billings, cost reports, kickbacks, etc.
Residential Rights
Maintain the
confidentiality
of all resident care information including protected health information. Report known or suspected incidents of unauthorized disclosure of such information.
Review complaints and grievances made by the resident and make a written/oral report to the Nursing Manager indicating what action(s) were taken to resolve the complaint or grievance.
Follow the facility's established procedures.Report all allegations of resident abuse and/or misappropriation of resident property.
Provide data to the Quality Assurance Committee as requested.
Participate in facility committees as required.
Coordinate cost effective, quality care assuring that cost containment does not take precedence over quality and safety.
Participate in the development, maintenance, and implementation of the facility's quality assurance program.
Participate in facility surveys (inspections) made by authorized government agencies as may be requested.
Requirements & Qualifications:
Must have, as a minimum, three (3) year's experience in a hospital, nursing care facility, or other related health care facility.
Must have a working knowledge of managed care rules, regulations, and guidelines.
Must possess a current, unencumbered, active license to practice as an RN in this state.
Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to managed care and nursing care facilities.
Must be willing to seek out new methods and principles and be willing to incorporate them into existing nursing practices.
Must be able to relate information concerning a resident's condition.Avamere Living is an Equal Opportunity Employer and participates in E-Verify.
Qualifications
Experience
Required
3 years:
3 years:
How many years of experience do you have working in a hospital, nursing care facility, or other related health care facility?
#J-18808-Ljbffr
