Monitor PDPM case mix, clinical categories, and reimbursement accuracy * Lead and coordinate interdisciplinary care plan meetings * Conduct internal audits to ensure documentation supports coding and ...
Quick apply
Monitor PDPM case mix, clinical categories, and reimbursement accuracy * Lead and coordinate interdisciplinary care plan meetings * Conduct internal audits to ensure documentation supports coding and ...
MDS Coordinator RN Preferred
South Bend, IN · On-site
$65 - $85/hr
Manage PDPM case mix including clinical categories, NTA scoring, and therapy minutes * Lead or co ... Conduct internal MDS audits to ensure coding accuracy and compliance * Educate nursing staff on ...
MDS Coordinator RN Preferred
South Bend, IN · On-site
$65 - $85/hr
Manage PDPM case mix including clinical categories, NTA scoring, and therapy minutes * Lead or co ... Conduct internal MDS audits to ensure coding accuracy and compliance * Educate nursing staff on ...
MDS Coordinator RN Preferred
South Bend, IN · On-site
$65 - $85/hr
Manage PDPM case mix including clinical categories, NTA scoring, and therapy minutes * Lead or co ... Conduct internal MDS audits to ensure coding accuracy and compliance * Educate nursing staff on ...
MDS Coordinator RN Preferred
South Bend, IN · On-site
$65 - $85/hr
Manage PDPM case mix including clinical categories, NTA scoring, and therapy minutes * Lead or co ... Conduct internal MDS audits to ensure coding accuracy and compliance * Educate nursing staff on ...
MDS Coordinator RN Preferred
South Bend, IN · On-site
$33.50 - $43/hr
Manage PDPM case mix including clinical categories, NTA scoring, and therapy minutes * Lead or co ... Conduct internal MDS audits to ensure coding accuracy and compliance * Educate nursing staff on ...
Quick apply
MDS Coordinator RN Preferred
South Bend, IN · On-site
$33.50 - $43/hr
Manage PDPM case mix including clinical categories, NTA scoring, and therapy minutes * Lead or co ... Conduct internal MDS audits to ensure coding accuracy and compliance * Educate nursing staff on ...
Corporate MDS Traveler
Indianapolis, IN · Hybrid
$88K - $97K/yr
Ensure compliance with state and federal regulations, Medicare requirements, PDPM, case-mix ... audits, survey preparation, and periods of high census. * Travel throughout the assigned region ...
Quick apply
Corporate MDS Traveler
Indianapolis, IN · Hybrid
$88K - $97K/yr
Ensure compliance with state and federal regulations, Medicare requirements, PDPM, case-mix ... audits, survey preparation, and periods of high census. * Travel throughout the assigned region ...
Regional Director of Clinical Reimbursment
South Bend, IN · On-site
$110 - $170/hr
Serve as a subject matter expert during audits, denials, and operational transitions Required ... Strong working knowledge of MDS, PDPM, Medicare, and reimbursement regulations * Excellent ...
Regional Director of Clinical Reimbursment
South Bend, IN · On-site
$110 - $170/hr
Serve as a subject matter expert during audits, denials, and operational transitions Required ... Strong working knowledge of MDS, PDPM, Medicare, and reimbursement regulations * Excellent ...
Regional Director of Clinical Reimbursment
South Bend, IN · On-site
$100K - $110K/yr
Serve as a subject matter expert during audits, denials, and operational transitions Required ... Strong working knowledge of MDS, PDPM, Medicare, and reimbursement regulations * Excellent ...
Quick apply
Regional Director of Clinical Reimbursment
South Bend, IN · On-site
$100K - $110K/yr
Serve as a subject matter expert during audits, denials, and operational transitions Required ... Strong working knowledge of MDS, PDPM, Medicare, and reimbursement regulations * Excellent ...
Conduct regular internal audits, risk assessments, and compliance reviews across clinical and ... Demonstrated knowledge of post-acute care regulations , including PDPM , Medicare Part A & B, and ...
Conduct regular internal audits, risk assessments, and compliance reviews across clinical and ... Demonstrated knowledge of post-acute care regulations , including PDPM , Medicare Part A & B, and ...
Familiar with the Patient-driven Payment Model (PDPM) and the value and impact of identifying those ... Assists with the team's QAPI program by executing audits and adhering to the established standards ...
Familiar with the Patient-driven Payment Model (PDPM) and the value and impact of identifying those ... Assists with the team's QAPI program by executing audits and adhering to the established standards ...
Familiar with the Patient-driven Payment Model (PDPM) and the value and impact of identifying those ... Assists with the team's QAPI program by executing audits and adhering to the established standards ...
Familiar with the Patient-driven Payment Model (PDPM) and the value and impact of identifying those ... Assists with the team's QAPI program by executing audits and adhering to the established standards ...
Familiar with the Patient-driven Payment Model (PDPM) and the value and impact of identifying those ... Assists with the team's QAPI program by executing audits and adhering to the established standards ...
Familiar with the Patient-driven Payment Model (PDPM) and the value and impact of identifying those ... Assists with the team's QAPI program by executing audits and adhering to the established standards ...
Familiar with the Patient-driven Payment Model (PDPM) and the value and impact of identifying those ... Assists with the team's QAPI program by executing audits and adhering to the established standards ...
Familiar with the Patient-driven Payment Model (PDPM) and the value and impact of identifying those ... Assists with the team's QAPI program by executing audits and adhering to the established standards ...
Familiar with the Patient-driven Payment Model (PDPM) and the value and impact of identifying those ... Assists with the team's QAPI program by executing audits and adhering to the established standards ...
Familiar with the Patient-driven Payment Model (PDPM) and the value and impact of identifying those ... Assists with the team's QAPI program by executing audits and adhering to the established standards ...
Pdpm Audit information
What is a PDPM audit?
A PDPM audit is an evaluation process that reviews how a skilled nursing facility implements the Patient-Driven Payment Model (PDPM). Auditors examine clinical documentation, coding, and billing practices to ensure compliance with Medicare regulations and to verify that residents are being accurately assessed and classified for payment. The goal is to identify errors or discrepancies that could lead to improper payments or regulatory issues, and to help facilities improve their processes for accurate reimbursement. Regular PDPM audits can help facilities avoid penalties and maintain financial stability.
What are the key skills and qualifications needed to thrive as a PDPM auditor?
To thrive as a PDPM Auditor, you need a solid understanding of Medicare reimbursement systems, MDS (Minimum Data Set) assessments, and skilled nursing facility regulations, typically supported by clinical credentials such as RN, LPN, or certification in MDS/RAI. Familiarity with electronic health record (EHR) systems, PDPM calculation software, and audit tools is essential. Strong analytical thinking, attention to detail, and effective communication skills help ensure accuracy and clarity when reviewing records and providing feedback. These skills are vital to optimize reimbursement, maintain regulatory compliance, and support quality patient care.
What are some common challenges faced by professionals conducting PDPM audits in skilled nursing facilities?
Professionals performing PDPM (Patient-Driven Payment Model) audits often encounter challenges such as ensuring accurate clinical documentation, keeping up with frequent regulatory changes, and effectively communicating findings to interdisciplinary teams. They must carefully review MDS assessments, therapy documentation, and nursing notes to verify compliance and reimbursement accuracy. Additionally, working collaboratively with clinical and administrative staff is crucial for implementing corrective actions and maintaining ongoing compliance.
What is the difference between Pdpm Audit vs Pdpm Compliance Officer?
| Aspect | Pdpm Audit | Pdpm Compliance Officer |
|---|---|---|
| Primary Role | Conducts audits to ensure adherence to Pdpm standards and regulations | Ensures organizational compliance with Pdpm policies and external regulations |
| Certifications | Often requires auditing or quality assurance certifications | Requires compliance or regulatory certifications |
| Work Environment | Auditing in various departments, often in a review or assessment capacity | Monitoring and implementing compliance measures across the organization |
| Industry Usage | Common in healthcare, manufacturing, and service sectors | Prevalent in healthcare, finance, and regulated industries |
While both roles focus on adherence to Pdpm standards, Pdpm Audits primarily evaluate compliance through assessments, whereas Pdpm Compliance Officers develop and oversee compliance programs to ensure ongoing adherence.
What are popular job titles related to Pdpm Audit jobs in Indiana?
For Pdpm Audit jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Pdpm Audit jobs in Indiana look for?
The top searched job categories for Pdpm Audit jobs in Indiana are:
What cities in Indiana are hiring for Pdpm Audit jobs?
Cities in Indiana with the most Pdpm Audit job openings:
Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 6 days ago
Job description
Newburgh Health and Rehab (formerly Newburgh Healthcare) is seeking an experienced Director of MDS (RN) to lead the clinical assessment and reimbursement process within our skilled nursing and rehabilitation facility.
This position plays a critical role in ensuring accurate assessments, regulatory compliance, strong interdisciplinary care planning, and optimized reimbursement under PDPM.
THIS POSITION IS NOT PART OF THE ON CALL ROTATION!
Key Responsibilities
Oversee completion, accuracy, and timeliness of all MDS assessments
Supervise and support one MDS nurse, providing guidance, auditing, and education
Ensure compliance with CMS, state, and federal regulations
Monitor PDPM case mix, clinical categories, and reimbursement accuracy
Lead and coordinate interdisciplinary care plan meetings
Conduct internal audits to ensure documentation supports coding and reimbursement
Educate nursing and IDT staff on documentation standards
Identify opportunities to improve case mix and reimbursement outcomes
Support survey readiness and participate during surveys and audits
Participate in QAPI and performance improvement initiatives
Qualifications
Active Indiana RN license or Compact license required
RAC-CT certification preferred
Minimum 1 year MDS experience in a skilled nursing setting
Strong knowledge of PDPM, CMS guidelines, and care planning regulations
Experience supervising or mentoring clinical staff preferred
Strong analytical, organizational, and communication skills
What We’re Looking For
We want someone who is:
Detail-driven and clinically strong
Confident in MDS coding and regulatory interpretation
Comfortable balancing hands-on work with light leadership
Proactive in identifying reimbursement and documentation opportunities
A collaborative partner to nursing, therapy, and billing teams
What We Offer
Competitive salary based on experience
Leadership role with direct impact on quality and reimbursement
Supportive leadership team
Health, dental, and vision benefits
Paid time off and holidays
401(k)
Ready to make a difference?
Apply today and join a team where your dedication is recognized and rewarded!
EEOC
We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.
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