Diversity, Equity, and Inclusion are at the heart of Cantex. We are committed to a culture that respects our differences and values the contributions of all people.
A peaceful community in the hill country of San Antonio
Perched on a hill above San Antonio's Stone Oak community, Coronado at Stone Oak is Spanish-style a 112-bed facility designed to blend in with local landmarks. Located near three hospitals and just minutes from downtown and the airport, our goal is to rehabilitate and transition patients back home with an average length of stay of two weeks.
The overall purpose of the Patient Care Coordinator position is to ensure appropriate reimbursement of Medicare and/or Medicaid Patients through the Patient Assessment Instrument (RAI) process. Assists in the management of quality Patient care on a continuing basis in accordance with federal and state standards and as may be directed by the Administrator or Director of Nursing.
- Maintains compliance with all State and Federal Medicaid and/or Medicare rules, regulations and published interpretations.
- Participates in the assessment of pre-admission paper work to ensure Patient meets qualifying medical necessity determination.
- Attends "standup" meetings every weekday morning.
- Coordinates the Weekly Reimbursement Meeting with the Interdisciplinary Team Members to ensure proper Medicare and/or Medicaid reimbursement to match care delivery.
- Audit the Clinical Record to ensure appropriate documentation for actual care delivery. Educates and trains staff on documentation guidelines.
- Obtains Medicare qualifying diagnosis (es) on Medicare Part A Patients and updates diagnosis for each change in diagnosis.
- Initiates and updates the physician certifications for each Medicare Part A Patient.
- Completes all Minimum Data Set (MDS) assessments within the allotted time frame for each Medicare and/or Medicaid Patient.
- Reviews the 24-hour Nursing report to capture possible change in condition of a Patient.
- Prepares for all Medicaid audits.
- Tracks Patient benefit days, validates daily census and coordinates information with Financial Manager to ensure accurate billing.
- Achieves at least budgeted rates expectation.
- Has reviewed Cantex Continuing Care Network Continuing Care Network Clinical Policies and Procedures for Abuse Prevention and knows the employee's responsibility to enforce it.
- Supports and upholds the Patient Care Management Systems as well as the Financial Management Systems.
- A current, valid Texas nursing license is required (RN, LVN)
- At least 2 years of LTC experience preferred.
- Must have an "Acknowledgement of Completion Certificate" through the HHSC RUG Online Training for Nursing Facilities.
- Must complete the American Association of Nurse Assessment Coordinators (AANAC) RAI Certification within 1 year of employment.
- Ability to effectively communicate, direct, and at times, delegate tasks.
- Ability to read, write, analyze and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
- Ability to write reports, business correspondence, nursing/Patient progress notes, and nursing procedures.
- Ability to effectively present information and respond to questions from department heads, customers, (Patients, family members, physicians, etc.) and the general public.
We are an Equal opportunity employer; We offer an excellent benefit plan to include 401K with match, CEU reimbursement, vacation, sick, holidays, medical, dental, and supplemental insurance Plans as well as a Highly competitive compensation package.