Job Description

MDS Coordinator

Company: Aliya Healthcare

Position: MDS Coordinator

Department: Clinical / MDS

Employment Type: Full-Time

Reports To: Director of Nursing / Administrator

Salary: Based on experience and qualifications

Employment Type: Full-Time

The MDS Coordinator is responsible for coordinating and overseeing the facility’s Minimum Data Set (MDS) assessment and Resident Assessment Instrument (RAI) process to ensure accurate, timely, and compliant assessments and appropriate clinical reimbursement. This position works closely with nursing, therapy, restorative, medical, and administrative teams to ensure compliance with federal and state regulations and facility policies.

The MDS Coordinator reviews clinical documentation, monitors Medicare and managed care residents, completes and coordinates MDS assessments, identifies documentation and compliance concerns, and provides education to facility staff regarding MDS, Medicare, RAI, and reimbursement requirements.

RN and MDS certification/experience preferred.

Essential Job Functions

The responsibilities listed below are representative of the position and are not intended to be an exhaustive list of all duties. Additional responsibilities may be assigned based on the needs of the facility.

MDS & RAI Management

• Coordinate and complete MDS assessments accurately and within required regulatory timeframes.

• Ensure the RAI/MDS process is completed in accordance with federal and state regulations.

• Review resident clinical records to ensure accurate assessments, documentation, coding, and transmission.

• Ensure all required supporting documentation is present before MDS coding.

• Monitor MDS completion and submission to ensure deadlines are consistently met.

• Identify discrepancies, documentation gaps, and areas requiring correction or follow-up.

• Collaborate with nursing, therapy, restorative, dietary, social services, and other interdisciplinary team members throughout the assessment process.

Medicare & Reimbursement Oversight

• Participate in weekly Medicare meetings on a consistent schedule.

• Monitor and evaluate Medicare admissions and discharges.

• Review all residents receiving Medicare coverage and monitor their clinical and documentation status.

• Review Medicare documentation to ensure skilled nursing and therapy needs are appropriately supported.

• Ensure daily nursing and therapy documentation supports the resident's skilled level of care.

• Review documentation for Medicare Part B services and ensure required supporting documentation is present.

• Monitor compliance with applicable Medicare rules, regulations, and utilization requirements.

• Review ABN tracking to ensure required documentation is completed, maintained, and distributed timely.

• Ensure the physician certification and recertification process is completed accurately and timely.

• Monitor applicable reimbursement processes and identify opportunities to improve accuracy and compliance.

Compliance & Quality Assurance

• Evaluate facility compliance with federal and state regulations related to MDS, RAI, Medicare, utilization, and clinical documentation.

• Identify areas of concern and assist facility leadership in developing and implementing corrective action plans.

• Monitor documentation for accuracy, completeness, and consistency.

• Ensure required documentation is available to support resident assessments and reimbursement.

• Assist with preparation for regulatory surveys, audits, and reviews involving MDS, Medicare, and clinical documentation.

• Maintain current knowledge of CMS requirements, RAI guidelines, Medicare regulations, and applicable state requirements.

• Promote consistent compliance with facility policies and regulatory standards.

Staff Education & Training

• Educate nursing and interdisciplinary staff regarding MDS, RAI, Medicare requirements, documentation standards, and reimbursement practices.

• Provide ongoing education regarding regulatory changes and facility compliance requirements.

• Identify training needs and assist with implementing appropriate educational programs.

• Provide guidance to staff regarding documentation necessary to support skilled services and accurate MDS coding

Qualifications

• Registered Nurse (RN) preferred.

• Current, active nursing license in the applicable state, if required by the position.

• MDS certification preferred.

• Prior MDS Coordinator experience strongly preferred.

• Experience with the MDS/RAI process in a skilled nursing or long-term care setting preferred.

• Knowledge of Medicare, Medicaid, RAI, MDS, reimbursement, and skilled documentation requirements.

• Strong understanding of federal and state regulations applicable to skilled nursing facilities.

• Experience reviewing clinical documentation and identifying compliance issues.

• Strong organizational and time-management skills.

• Excellent written and verbal communication skills.

• Ability to work collaboratively with interdisciplinary teams.

• Strong attention to detail and ability to meet regulatory deadlines.

• Proficiency with electronic medical records and MDS-related software systems, preferably PointClickCare or similar platforms.

Core Competencies

• MDS/RAI knowledge

• Medicare and reimbursement knowledge

• Regulatory compliance

• Clinical documentation review

• Critical thinking and problem-solving

• Attention to detail

• Organization and time management

• Staff education and training

• Interdisciplinary collaboration

• Communication and professionalism