CLINICAL REIMBURSEMENT SPECIALIST
Company: Liberty Health
Location: Wilmington
Posted on: March 19, 2026
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Job Description:
Job Description Job Description CLINICAL REIMBURSEMENT
SPECIALIST Liberty Cares With Compassion At Liberty Healthcare and
Rehabilitation Services, we promote a challenging, but rewarding
opportunity in a caring environment. We are currently seeking an
experienced: CLINICAL REIMBURSEMENT SPECIALIST JOB SUMMARY: -
Consults with assigned nursing facilities on a routine basis. -
Monitors Medicaid Case Mix, Patient Driven Payment Model Metrics,
Managed Care metrics and other payment metrics as indicated. -
Facilities facility reviews to ensure that accurate coding of the
MDS is completed in order to ensure maximum allowable
reimbursement. - Conducts targeted site reviews for assigned
facilities at least a semiannual basis. These reviews will include
validating accuracy of coding and supportive documentation for
various payer types. - Provides facility with a typed report of
visits that provides a score indicating compliance with
expectations. - Monitors the facility’s compliance with the
standard policies and procedures implemented by Liberty
Healthcare-Long Term Care. - Responds to questions by facility
staff concerning the policies and procedures and RAI process. -
Reviews and updates current policies and procedures according to
federal/state requirements and current standards of practice. -
Attends educational sessions pertinent to Long Term Care. - Assist
with MDS as needed. - Works with other departments as needed to
improve Quality of Care or to improve the process in which we
conduct business. - Works with pharmacy, medical supply company and
other vendors to evaluate MCA services provided in the facilities.
- Assist new facilities in the implementation of Policies and
Procedures. - Assist with orientation of new MDS Coordinators when
needed. - Coordinates or participates in education sessions for the
facilities such as DON meetings and new policy and procedure
training. - Review MDS scheduler to ensure that facility MDS is
current. JOB REQUIREMENTS: - Must be a High School graduate - Must
be a Registered Nurse, graduated from an accredited School of
Nursing, and have a current, valid RN license from the Board of
Nursing in the state of assignment and submit proof of license
renewal every other year. - Willing to serve as MDS coordinator in
a facility during vacancies in that position. - Dependable,
flexible, and able to work and cooperate well with all nursing
personnel, other departments and have understanding, patience, and
tact in working with patients, families, doctors, and others. -
Ability to make decisions regarding nursing problems. - Able to
teach, instruct and direct orientation, continuing education,
in-service as needed. - Must read, know, and follow personnel,
department and Facility policies and procedures and adhere to
local, state, and federal requirements. - Must have working
knowledge of the rules and regulations related to Long Term Care. -
Must have Long Term Care experience. - Extensive traveling to
include overnight stays - Must have a neat professional appearance
at all times. PIc94f1fe9d418-25405-39959392
Keywords: Liberty Health, Greenville , CLINICAL REIMBURSEMENT SPECIALIST, Healthcare , Wilmington, North Carolina
