Clinical Reimbursement Specialist

Make a measurable impact on patient care while ensuring accurate, timely reimbursement that keeps our care strong. As a Clinical Reimbursement Specialist, you’ll translate clinical excellence into correct monetary reimbursement by reviewing patient records, overseeing MDS/RAI processes, and partnering with interdisciplinary teams—all in alignment with Life Care standards and applicable regulations

• Meaningful work:
  Your expertise directly supports quality of care and organizational sustainability.
• Collaborative team:
  Work closely with Nursing, Therapy, Admissions, and Finance.
• Professional growth:
  Ongoing education, compliance training, and clear advancement pathways.
• Values-driven culture:
  Integrity, respect, and patient-first care.

• Lead accurate, timely MDS/RAI assessments and documentation to ensure appropriate reimbursement.
• Review clinical records to validate coding accuracy and payer alignment across insurance programs.
• Monitor changes in condition and payer rules; advise teams to optimize compliant reimbursement.
• Educate clinical staff on documentation standards, policies, and regulatory changes.
• Collaborate with the interdisciplinary team to align care plans with reimbursement requirements.
• Uphold Life Care policies, safety standards, and Code of Conduct.
• Support emergency procedures, including safe patient evacuation when needed.

• Registered Nurse (RN) with an active state license.
• Demonstrated MDS/RAI experience in post‑acute or long‑term care.
• Strong knowledge of federal/state regulations, payer guidelines, and facility procedures.
• Sound judgment and independent decision‑making in dynamic situations.
• Proficiency in patient rights, safety, sanitation, and confidentiality standards.
• Clear, professional communication and teamwork skills.
• Reliability, integrity, and a positive, service‑oriented attitude.
• Ability to read, write, speak, and understand English.
• Physical ability to sit, stand, bend, lift, push, pull, stoop, walk, reach, and move intermittently during working hours.

• Competitive pay with opportunities for performance‑based increases.
• Paid time off and paid training, including mandatory compliance and Code of Conduct courses.
• Supportive leadership and a culture that invests in your success.

• Detail‑focused, deadline‑driven, and highly organized.
• Comfortable educating peers and influencing cross‑functional teams.
• Committed to compliance and continuous improvement.

At Life Care, our mission is to deliver exceptional post‑acute and long‑term care with compassion and integrity. Join a team where your expertise helps patients and residents receive the right care—and the organization receive the right reimbursement—to thrive.