Regional Clinical Reimbursement Consultant – State Veterans Homes

Oversee clinical reimbursement operations across multiple skilled nursing facilities, ensuring accurate and compliant MDS assessments in accordance with CMS requirements. Monitor PDPM performance, case-mix accuracy, and reimbursement trends while identifying opportunities to optimize revenue without compromising clinical integrity. Provide guidance to MDS Coordinators and facility leadership on interdisciplinary documentation, care area assessments, and care planning processes. Support internal and external audits, lead corrective action plans for reimbursement findings, and develop education on PDPM, ICD-10 coding, and documentation standards. Analyze revenue data, provide recommendations to regional leadership, and resolve billing denials by partnering with clinical and business teams. This role requires extensive travel throughout the assigned region and active collaboration with clinical, financial, and operational leaders to drive outcomes.