reimbursement coordinator

Genesis Healthcare

<div>Overview:
<div>At Genesis Healthcare, we are dedicated to improving the lives we touch through the delivery of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in fostering a collaborative, inclusive and supportive work environment where every team member is valued and empowered to make a difference. Whether you're an experienced professional or just starting your career, we offer opportunities for growth, development, and advancement in a range of roles. Join us in our mission to enhance the well-being of our patients and residents while making a meaningful impact in the communities we serve.</div>
Responsibilities:
<div><div>The MDS Nurse - RN manages the overall process and tracking of all Medicare/Medicaid case-mix documents to ensure appropriate reimbursement for all services provided within the nursing.</div><div>
</div><ul><li>Maintain an accurate schedule of all MDS assessments to include the proper reference dates throughout the patient stay and ensures the accurate and timely submission of the MDS assessments including case-mix, OBRA and OSRA required assessments.</li><li>Perform concurrent MDS review to insure appropriate RUGs category is achieved through the capture of appropriate clinical information and in this process identify opportunities to enhance reimbursement.</li><li>Communicate case-mix data required for billing to the Business Office such as RUGs categories, modifiers, state case-mix scores, etc.</li><li>Serve as the nursing center resource for MDS/RUGs and state case-mix systems providing staff case-mix education and instruction on MDS terminology and format.</li></ul></div>
Qualifications:
<ul><li>Must be a graduate of an accredited School of Nursing with current RN licensure in the state in which employment occurs is required.</li><li>One year of long term care clinical nursing experience is required.</li><li>Experience with Medicare/Medicaid reimbursement, MDS completion, clinical resource utilization and/or case management is highly desirable.</li><li>Must maintain current BLS/CPR certification (excluding ALFs/ILFs).</li></ul>
Benefits:
<div><ul><li>Variable compensation plans</li><li>Tuition, Travel, and Wireless Service Discounts</li><li>Employee Assistance Program to support mental health</li><li>Employee Foundation to financially assist through unforeseen hardships</li><li>Health, Dental, Vision, Company-paid life insurance, 401K, Paid Time Off</li><li>Free 24/7 virtual health care provided by licensed doctors for all Anthem medically-enrolled employees and their immediate family members</li><li>On-Demand Pay Program that allows for instant access to a portion of the money you&rsquo;ve already earned</li></ul><div></div><div><br>
We also offer several voluntary insurances such as:<br>
<ul><li>Pet Insurance</li><li>Term and Whole Life Insurance</li><li>Short-term Disability</li><li>Hospital Indemnity</li><li>Personal Accident</li><li>Critical Illness</li><li>Cancer Coverage</li></ul></div><div></div><div><br>
Restrictions apply based on collective bargaining agreements, applicable state law and factors such as pay classification, job grade, location, and length of service.</div></div><div></div>
Posted Salary Range: USD $85,000.00 - USD $90,000.00 /Hr.</div>

Clinical Reimbursement Coordinator, RN

Novartis

<div><div><h3 class="jobSectionHeader"><b>Summary
</b></h3><div>The Team Leader, Data Enablement &ndash; Access &amp; Reimbursement, is a hands-on leader responsible for identifying and executing data enablement opportunities that drive optimal access and reimbursement for our products. Reporting to the Associate Director, this role works closely with associates to understand business requirements, strategize innovative data solutions, and ensure flawless execution with a commitment to accuracy. The Team leader will collaborate with cross-functional teams and third-party vendors, bringing value through data-driven innovation and maintaining the highest standards in delivery.</div>
</div><div><h3 class="jobSectionHeader"><b>About the Role
</b></h3><div><p><b>Team Leader, Data Enablement &ndash; Access &amp; Reimbursement</b></p><p><b>
Location &ndash; Hyderabad #LI Hybrid</b></p><p></p><p><b>
Major Responsibilities:</b></p><ul><li>
Partner with associates and stakeholders to deeply understand business requirements and translate them into actionable data strategies and solutions.</li><li>
Lead hands-on data enablement activities for reimbursement analytics, supporting product launches and lifecycle management with ability to partner within Access &amp; Reimbursement group for fostering collaboration.</li><li>
Strategize, design, and implement innovative data solutions that address business challenges and create measurable value. Maintain absolute accuracy and integrity in all data deliverables, ensuring compliance with internal and external standards.</li><li>
Analyse payer policies and reimbursement trends, identifying data opportunities and risks, and translating findings into actionable recommendations. Collaborate with Novartis Patient Support (NPS), Market Access, Commercial, and other IDS teams to execute data strategies and ensure alignment with business objectives.</li><li>
Manage relationships with third-party vendors, overseeing data acquisition, integration, and quality assurance. Mentor and develop associates, fostering technical growth and a collaborative team environment.</li><li>
Monitor and report on the effectiveness of data enablement initiatives, providing regular updates and recommendations for continuous improvement.</li><li>
Stay current on healthcare regulations and payer policy changes, proactively communicating relevant updates to the team.</li></ul><p></p><p><b>
Minimum Requirements:</b></p><ul><li>
Bachelor&rsquo;s degree in engineering, marketing, Data Science, Business, or a related field; master&rsquo;s degree preferred.</li><li>
7&ndash;10 years of experience in the pharmaceutical or healthcare industry, with a strong focus on Patient Services and Market access and data enablement.</li><li>
At least 2&ndash;3 years of people management or team leadership experience, with a demonstrated ability to work closely with associates.</li><li>
Strong understanding of Patient Journey, consent management including HIPAA, TCPA. Experience on Hub and Specialty Pharmacy services</li><li>
Proven hands-on experience in data analytics, functional reporting, and operational problem-solving.</li><li>
Strong analytical and technical skills, with the ability to interpret complex data sets and drive data-driven decisions.</li><li>
Excellent communication and interpersonal skills, with a focus on cross-functional collaboration.</li><li>
Ability to thrive in a fast-paced, dynamic environment and manage multiple priorities. High attention to detail and commitment to data accuracy.</li></ul><p></p><p><b>
Values and Behaviours</b>:</p><p><b>
Location:</b> Hyderabad NKC. Hybrid | 3 days a week in office is mandatory</p><p></p><p><b>
Key Performance Indicators:</b></p><ul><li>
Work experience in Market Access, Payer, and Channel strategy is highly desired.</li><li>
Strong data engineering skills are highly appreciated.</li><li>
Agility and adaptability in managing changing priorities.</li><li>
Cross-functional collaboration and stakeholder engagement.</li><li>
Customer insights and experience.</li><li>
Data analytics and strategy.</li><li>
Experience with waterfall &amp; Agile model project management.</li></ul><p></p><p><b>
Why Novartis:</b> Our purpose is to reimagine medicine to improve and extend people&rsquo;s lives and our vision is to become the most valued and trusted medicines company in the world. How can we achieve this? With our people. It is our associates that drive us each day to reach our ambitions. Be a part of this mission and join us! Learn more here: https://www.novartis.com/about/strategy/people-and-culture<br>
<br>
<b>You&rsquo;ll receive:</b> You can find everything you need to know about our benefits and rewards in the Novartis Life Handbook. https://www.novartis.com/careers/benefits-rewards<br>
<br>
<b>Commitment to Diversity and Inclusion:</b><br>
Novartis is committed to building an outstanding, inclusive work environment and diverse teams' representative of the patients and communities we serve.<br>
<br>
<b>Join our Novartis Network:</b> If this role is not suitable to your experience or career goals but you wish to stay connected to hear more about Novartis and our career opportunities, join the Novartis Network here: https://talentnetwork.novartis.com/network.</p></div><p></p>
</div><div><div><p><b>Why Novartis:</b> Helping people with disease and their families takes more than innovative science. It takes a community of smart, passionate people like you. Collaborating, supporting and inspiring each other. Combining to achieve breakthroughs that change patients&rsquo; lives. Ready to create a brighter future together? https://www.novartis.com/about/strategy/people-and-culture</p><p><b>
Benefits and Rewards:</b> Read our handbook to learn about all the ways we&rsquo;ll help you thrive personally and professionally: https://www.novartis.com/careers/benefits-rewards</p></div></div></div>
<br><div><div>Division
<div>US
</div></div><div>Business Unit
<div>General Management
</div></div><div>Location
<div>India
</div></div><div>Site
<div>Hyderabad (Office)
</div></div><div>Company / Legal Entity
<div>IN10 (FCRS = IN010) Novartis Healthcare Private Limited
</div></div><div>Functional Area
<div>Marketing
</div></div><div>Job Type
<div>Full time
</div></div><div>Employment Type
<div>Regular
</div></div><div>Shift Work
<div>No
</div></div><div></div><div><p>Novartis is committed to building an outstanding, inclusive work environment and diverse teams' representative of the patients and communities we serve.</p>
</div><div><h3 class="jobSectionHeader"><b>Accessibility and accommodation</b></h3><p>
Novartis is committed to working with and providing reasonable accommodation to individuals with disabilities. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the recruitment process, or in order to perform the essential functions of a position, please send an e-mail to [email protected] and let us know the nature of your request and your contact information. Please include the job requisition number in your message.</p></div></div>

Team Leader, Data Enablement – Access & Reimbursement

Al Riyady For Auditing of Accounts EST

<p><b>Location:</b> Business Bay, Dubai<br/><b>Industry:</b> Medical Centre<br/><b>Position:</b> Full-time<br/><b>Working Days:</b> 5 days per week (2 days off)<br/><b>Salary:</b> AED 8,000 &ndash; 10,000<br/><b>Joining:</b> Immediate Joiner Required</p><p><b>Position Summary</b></p><p>The Insurance Claims Coordinator will be responsible for managing the full cycle of medical insurance claims, from submission to reconciliation, ensuring accuracy, compliance, and timely processing. The role requires strong knowledge of UAE insurance guidelines, RCM procedures, and hands-on experience within reputable medical centers. The ideal candidate must be highly detail-oriented, organized, and experienced in optimizing claim approvals and minimizing rejections.</p><p><b>Key Responsibilities</b></p><ul><li>Prepare, review, and submit medical insurance claims accurately and on time.</li><li>Handle daily reconciliation of submitted claims, payments, and rejections.</li><li>Manage the full Revenue Cycle Management (RCM) process, ensuring compliance with UAE healthcare insurance standards.</li><li>Review patient insurance coverage, eligibility, and approvals.</li><li>Follow up on pending, rejected, or underpaid claims and coordinate resubmissions.</li><li>Maintain updated records of claims, approvals, rejections, and reconciliations.</li><li>Coordinate with physicians, nurses, and billing teams to support accurate claim entries.</li><li>Assist in audits, reporting, and documentation requirements.</li><li>Identify process gaps and recommend improvements to minimize claim denials.</li></ul><p><b>Skills &amp; Qualifications</b></p><ul><li><b>4&ndash;5 years of UAE experience in insurance claims, medical billing, and RCM within a reputable clinic or medical facility.</b></li><li>Strong knowledge of UAE insurance regulations, payer portals, coding standards, and claim categories.</li><li>Hands-on experience in claims submission software and EMR systems.</li><li>Excellent analytical, reconciliation, and documentation skills.</li><li>Strong communication skills with the ability to liaise with insurance companies and internal departments.</li><li>High level of accuracy, integrity, and ability to work independently in a fast-paced environment.</li></ul><p>Job Types: Full-time, Permanent</p><p>Pay: AED8,000.00 - AED10,000.00 per month</p><p>Application Question(s):</p><ul><li>Nationality?</li><li>How many years of UAE experience in insurance claims, medical billing, and RCM within a reputable clinic or medical facility do you have?</li><li>Expected Salary?</li><li>Immediate Joiner?</li></ul>

Insurance Claims Coordinator - UAE Healthcare (Reconciliation & RCM experience)

Touchstone Communities

<strong>RN OR LVN MDS Coordinator - Make an Impact in Skilled Nursing & Reimbursement!</strong> <p>Are you an <strong>RN/LVN with MDS experience</strong> looking for a <strong>rewarding career</strong> in a skilled nursing facility? Do you have a passion for <strong>accuracy, compliance, and maximizing reimbursement</strong> while ensuring residents receive the highest quality care? If so, we want <strong>YOU</strong> to join our team at Harker Heights Nursing & Rehab<strong>!</strong></p> <p>As an <strong>RN MDS Coordinator</strong>, you'll play a <strong>critical role</strong> in the success of our community by overseeing the <strong>MDS assessment and reimbursement process</strong>, ensuring we continue to provide <strong>exceptional care</strong> while maintaining financial and regulatory excellence.</p> <strong>What You'll Do:</strong> <ul> <li><strong>Lead the MDS process</strong> to ensure accurate and timely assessments for Medicare, Medicaid, and case management reimbursement.</li> <li>Work closely with <strong>clinical and financial teams</strong> to optimize reimbursement and compliance.</li> <li>Stay up to date on <strong>state and federal regulations</strong> related to RAI and reimbursement.</li> <li>Collaborate with <strong>interdisciplinary teams</strong> to develop individualized care plans that meet residents' needs.</li> <li>Ensure accuracy in <strong>documentation, assessments, and coding</strong> to support high-quality resident outcomes.</li> </ul> <strong>What You Bring:</strong> <ul> <li><strong>Active Texas RN OR LVN/LPN license</strong> (or valid Compact State RN license).</li> <li>Strong understanding of the <strong>Medicare, Medicaid, and case management reimbursement system</strong>.</li> <li><strong>Experience in Skilled Nursing Facilities (SNF) as an MDS Nurse</strong> preferred.</li> <li>Knowledge of <strong>state and federal regulations</strong> related to RAI and reimbursement.</li> <li>Detail-oriented mindset with <strong>excellent organizational and communication skills</strong>.</li> </ul> <strong>What's in It for YOU?</strong> <ul> <li><strong>A workplace where your voice matters</strong>-your expertise is valued!</li> <li><strong>Competitive compensation + paycheck advances</strong> for financial flexibility.</li> <li><strong>Tuition reimbursement</strong>-invest in your professional growth.</li> <li><strong>401(k) matching</strong>-plan for your future with confidence.</li> <li><strong>Paid Time Off (PTO)</strong>-start accruing from <strong>day one</strong>!</li> <li><strong>Bonus opportunities</strong>-we recognize and reward your hard work.</li> <li><strong>Touchstone Emergency Assistance Foundation Grants</strong>-support when you need it most.</li> </ul> <strong>Make Lives Better - Be Part of Something Meaningful!</strong> <p>We believe that <strong>MDS Nurses</strong> play a vital role in ensuring <strong>quality care and financial sustainability</strong>. If you're looking for <strong>a career with purpose</strong>, where <strong>your expertise directly impacts residents and the success of our community</strong>, we invite you to apply today and become a part of <strong>Team Touchstone!</strong></p> <p><strong>Apply now and take the next step in your MDS career!</strong></p>

MDS Coordinator

Hortus Ventures Private Limited (Chefouse)

<p><b>Job Title:</b> Project / Operations Coordinator</p><p><b>Location:</b> Calicut<br/><b>Experience:</b> 1&ndash;4 Years<br/><b>Employment Type:</b> Full-Time</p><p><b>Job Description</b></p><p>We are looking for a proactive and well-organized <b>Project / Operations Coordinator</b> to support new unit development, coordination activities, and on-ground execution. The ideal candidate should have strong follow-up skills and be comfortable working across teams, vendors, and project sites.</p><p><b>Key Responsibilities</b></p><ul><li>Coordinate new unit development activities and follow up with contractors, vendors, consultants, and internal teams</li><li>Handle legal, statutory, and compliance coordination and documentation</li><li>Support planning and execution of events, launches, and marketing campaigns</li><li>Travel to project sites, offices, and event locations as required</li><li>Ensure timely communication, follow-ups, and progress tracking across activities</li></ul><p><b>Requirements</b></p><ul><li>Graduate with <b>1&ndash;4 years</b> of experience in coordination, operations, or a similar role</li><li>Strong communication, follow-up, and execution skills</li><li>Willingness to travel and work on-field</li><li>Ability to manage multiple tasks and meet timelines</li></ul><p><b>Preferred Skills</b></p><ul><li>Basic knowledge of documentation and compliance processes</li><li>Good coordination and interpersonal skills</li><li>MS Office / Google Workspace proficiency</li></ul><p><b>Interested candidates can apply with their updated CV.</b></p><p>Job Types: Full-time, Permanent</p><p>Pay: ₹20,000.00 - ₹25,000.00 per month</p><p>Benefits:</p><ul><li>Cell phone reimbursement</li><li>Commuter assistance</li><li>Internet reimbursement</li><li>Life insurance</li><li>Paid time off</li></ul><p>Work Location: In person</p>

Junior Project Coordinator

Arcadia LTC

<div><p><b>MDS / Care Plan Coordinator</b></p>
<p><b>
Registered Nurse RN or Licensed Practical Nurse LPN</b></p>
<p><b>
Job Summary:</b></p>
<p>
The MDS / Care Plan Coordinator is responsible for assuring the timely completion of accurate resident assessments and interdisciplinary care plans that meet Federal and State guidelines. This includes identifying resident acuity and needs, helping to determine specific care needs, and communicating needs and expectations to families and responsible parties.</p>
<p><b>
Essential Duties:</b></p>
<ul><li> Responsible for integrating nursing, dietary, social recreation, restorative, rehabilitation, and physician services to ensure appropriate assessment and reimbursement.</li></ul>
<ul><li> Responsible for completion of all Medicare/Medicaid case-mix documents to assure appropriate reimbursement for care and services provided within the Facility.</li></ul>
<ul><li> Conducts continual Minimum Data Set (MDS) reviews to assure achievement of optimal allowable Resource Utilization Group (RUG) category.</li></ul>
<ul><li> Oversees the overall process and tracking of MDS/Prospective Payment System (PPS) documentation and submission.</li></ul>
<p><b>
Benefits Offered:</b></p>
<ul>
<li><p>Extremely low-cost Health, Dental, Vision, 401K, and more</p>
</li>
<li><p>$25,000 Company Paid Life Insurance &ndash; at no cost to you</p>
</li>
<li><p>Leadership Training to enhance your management skills</p>
</li>
<li><p>Daily Pay - get your money when you want</p>
</li>
<li><p>Paid Vacations - rolls over each year</p>
</li>
<li><p>Paid Sick Time</p>
</li>
<li><p>Paid Holidays</p>
</li>
<li><p>Tuition Reimbursement</p>
</li>
<li><p>Daily, Weekly, Monthly Employee Appreciation Events</p>
</li>
<li><p>Birthday, Anniversary Celebrations</p>
</li>
<li><p>Free Employee Assistance Programs - professional support &amp; guidance on family, money, health, legal services and more</p>
</li>
<li><p>Huge Discounts at all major retailers (Walmart, Costco, etc.) at no cost to you</p>
</li>
<li><p>Virtual Visits with Doctors 24/7, without setting up additional accounts or appointments</p>
</li>
<li><p>Paid Break Time for Nursing Mothers</p>
</li>
<li><p>Time Off to Vote</p></li></ul><br>
<p>
</p><p><b>Preferred Qualifications:</b></p>
<ul><li> Registered Nurse with current unencumbered state licensure.</li></ul>
<ul><li> Long Term Care Experience preferred.</li></ul>
<ul><li> Ability to read, write, speak, and understand the English language.</li></ul>
<p>
 #ACL NRS</p></div><p></p>

MDS Care Plan Nurse (RN/LPN)

ADVARISE HEATLHCARE SERVICES PVT LTD

<p><b>Job Title: Nursing Coordinator &amp; Operations &ndash; Home Healthcare</b><br/><b>Company:</b> AdvArise Healthcare Services Pvt Ltd<br/><b>Location:</b> Ambattur, Chennai<br/><b>Job Type:</b> Full-time | Immediate Joiners Preferred</p><p><b>About the Role:</b></p><p>AdvArise Healthcare Services is seeking a <b>Nurse Coordinator &amp; Office Administrator</b> to manage both <b>Home Healthcare Operations</b> and <b>Office Administration</b>.<br/>The role suits someone from a <b>nursing background</b> who is confident in handling <b>staff, patients, clients, and administrative systems</b> &mdash; along with <b>recruiting and sourcing new nursing candidates</b> for our growing operations.</p><p><b>Key Responsibilities:</b></p><ul><li>Coordinate and manage <b>Home Healthcare Staffs &amp; Patient Assignments</b>.</li><li>Handle <b>Client Calls, Enquiries, and Daily Case Updates</b>.</li><li>Maintain <b>Accounts, Attendance, and Records</b> using <b>Tally / Google Sheets</b>.</li><li>Draft and manage <b>Emails, Reports, and Documentation</b>.</li><li>Act as the <b>Office In charge</b> ensuring smooth day-to-day operations.</li><li>Assist in <b>sourcing, screening, and onboarding qualified nursing and caretaker candidates</b>.</li><li>Support management in <b>staff scheduling, deployment, and background verification</b>.</li><li>Travel to <b>clients&rsquo;, patients&rsquo;, and staffs&rsquo; locations</b> for coordination, when required.</li></ul><p><b>Qualifications &amp; Skills:</b></p><ul><li><b>Nursing Qualification (Mandatory):</b> B.Sc Nursing / GNM / DGNM / ANM / <b>Diploma in Nursing</b>.</li><li>Proficient in <b>Tally, MS Office, Google Sheets, and Mailing</b>.</li><li>Must be <b>from Ambattur or nearby areas</b>.</li><li>Must <b>know to drive a two-wheeler</b> with a <b>valid driving licence</b> (Travel required).</li><li>Strong communication skills in <b>English &amp; Tamil</b>.</li><li>Excellent <b>coordination, sourcing, and multitasking</b> skills.</li></ul><p><b>Work Details:</b></p><ul><li><b>Location:</b> AdvArise Healthcare Services,</li></ul><p>Crizone Business Centre, Mounaswamy Madam St, Secretariat Colony, Venkatapuram, Ambattur, Chennai &ndash; 600053.</p><ul><li><b>Work Type:</b> Office-Based (No Remote Work).</li><li><b>Timing:</b> 9:30 AM &ndash; 6:30 PM (Monday to Saturday).</li></ul><p><b>Salary:</b><br/>Competitive package based on experience and performance.</p><p><b>How to Apply:</b><br/><b>WhatsApp your Resume (No Calls):</b> <b>9840012162</b><br/><b>For Queries, Contact:</b> <b>98845 55656</b></p><p>Job Types: Full-time, Permanent, Fresher</p><p>Pay: ₹12,000.00 - ₹15,000.00 per month</p><p>Benefits:</p><ul><li>Cell phone reimbursement</li><li>Commuter assistance</li><li>Flexible schedule</li><li>Health insurance</li><li>Internet reimbursement</li><li>Paid time off</li></ul><p>Work Location: In person</p>

Nursing Coordinator & Operations – Home Healthcare

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