Regional Clinical Reimbursement Specialist

Our Clinical Reimbursement Specialist (MDS leadership) role supports our communities in Nebraska, South Dakota and Western Iowa.

Candidates must live in Eastern Nebraska or Western Iowa.

Candidates must be able to travel up to 75%

Company vehicle provided

Competitive Salary

Discretionary PTO

Upside Down Organization Chart - Our Employees are Valued and Heard

Accura Health Care is a Midwest-based healthcare company that manages and operates over 50 skilled nursing care, assisted living, independent living, and memory care communities throughout Iowa, Minnesota, South Dakota, and Nebraska. From its beginning in 2016 with 9 care communities, Accura Health Care has held true to its mission and vision while serving others. Built on the pillars of trust, integrity, accountability, commitment, and kindness, Accura Health Care is a leader in the Midwest in providing high-quality care.

Our employees play a key role in supporting our purpose, “to care for others,” while advancing our mission “to be partners in care, family for life.”

OUR BRANDS: Accura Health Care | Stonebridge Suites | Traditions Memory Care

OUR VALUES: Trust. Integrity. Accountability. Commitment. Kindness.

Accura Health Care is where personal life and work life blend together to bring value and purpose to one’s existence.

The Regional Clinical Reimbursement Specialist is responsible for providing consulting services, support and training to ensure facilities receive accurate reimbursement for multiple long‑term care, skilled nursing and assisted living facilities within a designated region, ensuring compliance with state and federal regulations and company policies and procedures.

• Provide leadership and consulting assistance to the Directors of Nursing, MDS Coordinators, and other stakeholders through audits, training, on‑site visits, and virtual meetings for multiple long‑term care facilities within the designated region.
• Utilize nursing knowledge and experience to provide guidance, ensure effective clinical practices and the highest quality of clinical reimbursement services.
• Develop and improve processes to ensure Minimum Data Set (MDS) accuracy and timeliness.
• Support MDS Coordinators ensuring compliance and knowledge of reimbursement regulations, documentation, policies and procedures, restorative program, Case Mix Index (CMI), Quality Measures (QM), Quality Assurance and Performance Improvement (QAPI) and Person‑Centered Care Planning and other quality associated initiatives.
• Develop and promote initiatives to improve star ratings.
• Review and complete audits of MDS data in Point Click Care (PCC).
• Conduct virtual and on‑site trainings.
• Acknowledge and promote Resident Rights treating all residents fairly, and with kindness, dignity, and respect while maintaining resident confidentiality in accordance with HIPAA.
• Reports all accidents and incidents, alleged reports of abuse or misappropriation of property, complaints, and grievances.
• Report any hazardous conditions or infectious disease to the Director of Nursing Services and/or to the Infection Control Coordinator.
• Follow all safety precautions in performance of duties and report all safety violations and/or concerns. Participate in all required in‑service trainings, competencies, perform assigned tasks and other duties as assigned, while ensuring all applicable laws, regulations, and company standards are met.
• May occasionally be on‑call with on‑site travel as required by the Vice President of Clinical Services.
• Available to work additional hours, as required to complete position tasks.
• Frequent travel is required, with overnight stays as needed.
• Performs other duties as assigned.

• Licensed RN
• 2+ years experience in long‑term care with proven leadership and management skills
• 3+ years experience in Clinical Reimbursement/MDS
• Proficiency with Point Click Care (PCC) preferred
• Strong knowledge of Medicare reimbursement regulations with specific focus on PDPM
• Working knowledge of nursing and rehabilitation services provided in long‑term care settings along with the MDS process, resident/patient care, and nursing standards of practice.
• Knowledge of long‑term care regulations and procedures as well as use of medical and nursing equipment and medications

• Paid Time Off (PTO) & Paid Holidays
• Medical, Dental, & Vision Benefits
• Flexible Spending Account
• Employer Paid Life & AD&D
• Supplemental Benefits
• Employee Assistance Program
• 401(k)

Accura Health Care, an Equal Opportunity Employer and leading post‑acute healthcare provider based in Iowa, has communities in Iowa, Minnesota, South Dakota, and Nebraska, and growing!