Urgently Hiring: MIPS Specialist – Skilled Nursing Facility Experience Required

ClaimFlow is a leading provider of revenue cycle management solutions and practice support tailored for healthcare practitioners and facilities. The company’s mission is to empower healthcare professionals to optimize their financial performance, allowing them to focus on delivering exceptional patient care. With a team of experienced specialists and advanced technology, ClaimFlow offers services including medical billing, credentialing, billing audits, practice management, and digital marketing. Their solutions are customized to meet the unique needs of each client, promoting efficient operations and sustainable growth within healthcare practices.

The MIPS Specialist role at ClaimFlow is a full-time, on-site position based in Lahore, specifically focused on skilled nursing facilities. This position involves managing all aspects of Merit-based Incentive Payment System (MIPS) reporting and compliance. The specialist will ensure accurate data collection, track quality measures, and guarantee timely submission of reports to regulatory bodies. Daily tasks include reviewing clinical and billing data, coordinating with facility staff to gather necessary documentation, monitoring performance metrics, and identifying opportunities to improve quality reporting. The role also requires staying up to date with evolving MIPS regulations, educating internal teams and clients on compliance requirements, and collaborating closely with revenue cycle and practice management teams to align quality initiatives with financial objectives.

Key Responsibilities
- Manage and oversee MIPS reporting and compliance for skilled nursing facilities.
- Review clinical and billing data to ensure accuracy and completeness.
- Coordinate with facility staff to collect required documentation for quality reporting.
- Monitor performance metrics and identify areas for improvement in quality measures.
- Stay current with MIPS regulations and communicate updates to internal teams and clients.
- Educate healthcare practitioners and administrative staff on MIPS requirements and best practices.
- Collaborate with revenue cycle and practice management teams to integrate quality initiatives with financial goals.
- Utilize healthcare software, EHR systems, and reporting tools to support data collection and analysis.

Required Qualifications
- Strong expertise in MIPS reporting, quality measures, and healthcare regulatory compliance.
- Hands-on experience working with skilled nursing facilities, including familiarity with their clinical workflows and documentation practices.
- Proficiency in healthcare data analysis, with the ability to review clinical and billing data for accuracy.
- Knowledge of revenue cycle management processes such as medical billing, coding fundamentals, and performance metrics.
- Ability to interpret and apply CMS and other regulatory guidelines to practical reporting scenarios.
- Excellent communication and collaboration skills to work effectively with clinical, administrative, and management teams.
- Strong organizational skills, attention to detail, and the ability to manage multiple facilities and deadlines simultaneously.
- Comfort with healthcare software, electronic health record (EHR) systems, and data reporting tools; advanced Excel skills are an advantage.
- Bachelor’s degree in healthcare administration, health information management, nursing, or a related field.

Preferred Qualifications and Benefits
- Relevant certifications in quality reporting or compliance are highly preferred.
- Prior experience in quality reporting, compliance, or performance improvement roles within healthcare settings is beneficial.

This role offers the opportunity to contribute to improving healthcare quality and financial outcomes by ensuring compliance with MIPS requirements in skilled nursing facilities. Candidates who are detail-oriented, knowledgeable about healthcare regulations, and skilled in data analysis will find this position rewarding and impactful.