RN Clinical Reimbursement Director

RN Clinical Reimbursement Director

Skilled Nursing Facility | Baltimore, MD

This organization is the area’s premier provider of services for older adults, proudly recognized for award-winning care and services. We are deeply committed to a workplace culture grounded in Connection, Empathy, Inclusion, and Advocacy.

We are currently seeking an experienced RN Clinical Reimbursement Director to lead and support our clinical reimbursement operations within our Skilled Nursing Facility. This is a permanent, full-time on-site position. 

Position Summary

The RN Clinical Reimbursement Director is responsible for overseeing all clinical reimbursement processes and managing an MDS team of three. This role ensures accurate, compliant, and timely completion of the Minimum Data Set (MDS) to support optimal reimbursement while reflecting the full clinical picture of each resident.

Key Responsibilities

• Oversees clinical reimbursement operations, ensuring accurate collection of initial and ongoing MDS data

• Manages and mentors an MDS team of three

• Demonstrates expertise in MDS completion to capture all services provided and support optimal reimbursement

• Identifies and applies appropriate coding to reflect full resident conditions, including ancillary and rehabilitation services

• Ensures compliance with federal and state regulations related to MDS and reimbursement

• Collaborates with interdisciplinary teams to ensure clinical documentation supports reimbursement accuracy

Qualifications

• Registered Nurse (RN), licensed and in good standing with the Maryland Board of Nursing (required)

• MDS experience and management experience within a skilled nursing facility (required)

• Resident Assessment Coordinator Certified (RAC-CT) certification preferred

• Strong knowledge of:

• Resident Assessment Instrument (RAI) Manual

• MDS coding and regulations

• ICD-10 coding

• Rehabilitation coding