REHAB SRV LINE PPS COORD

General Purpose of Job:

The Rehab Service Line PPS Coordinator will plan, organize, direct and evaluate the Acute Rehabilitation Medicare Prospective Payment System Process. This includes assignment of the CMG for each Medicare fee for service patient with expected Medicare reimbursement. In addition, oversees the coordination of the documentation, recording, data entry, data transmission, and analysis of the required Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) Items, CMG, assignment, identification of allowable co-morbidities, and the IRF-PAI assessment schedule.

Essential Duties:

This job description is intended to cover the minimum essential duties assigned on a regular basis. Associates may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

• Timely and accurate completion and submission of the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF/PAI) to CMS.
• Demonstrates knowledge of CMS regulations, clinical documentation requirements and referral policies and procedures. In addition, tracks changes in CMS rules and regulations.
• Performs reviews of patient medical records to verify supportive documentation for the IRF/PAI and CMS Medical Necessity.
• Assists, when needed, in pre-admission screening and referral process and participates in pre-admission education of patients admitted from within the institution
• Serves as primary resource and educator to hospital and medical staff regarding documentation, compliance, coding and reimbursement, and performance improvement opportunities.
• Monitors and reports PPS related outcomes, trends, opportunities.
• Communicates with coding staff/H.I.M. to provide information and guidance to achieve consistently appropriate diagnoses and co-morbidities along with physician guidance in decision-making process.
• Supports program operations as assigned.

Other Job Responsibilities:

• May participate in program development as assigned.
• May participate in orientation and training of new staff.
• Assists in maintaining clean and orderly treatment areas.
• Demonstrates competence in relevant software and hardware required to meet job responsibilities.