Coordinator Prospective Payment System - Inpatient Rehabilitation

McLaren Health Care•Pontiac, MI

56d•Hybrid

About The Position

The Coordinator Prospective Payment System (PPS) for the Inpatient Rehabilitation Unit is responsible for facilitating and coordinating the PPS. This role involves assisting with the screening process for potential candidates to the Rehabilitation Unit, ensuring patients meet admission criteria, and attending team conferences to assess data for the IRF-PAI and assist in developing the Individualized Plan of Care. The position requires staying current with Medicare regulations for Inpatient Rehabilitation Facilities/Units, managing the 60% compliance rule reporting and tracking, and preparing an annual report for state submission. Additionally, the role involves educating staff, physicians, coding, finance, and leadership on PPS system requirements, participating in performance improvement activities, running reports for data analytics, and ensuring accurate IRF-PAI completion and submission to secure proper payment and avoid penalties. The coordinator may also obtain pre-authorizations from payers as needed and perform other related duties.

Requirements

State licensure/certification in the field of nursing, physical therapy, occupational therapy, or speech language pathology.
Associate degree in discipline.
Two years in related health care field.

Nice To Haves

Bachelor’s degree
Licensure/certification in rehab discipline.

Responsibilities

Facilitates and coordinates the Prospective Payment System (PPS) for the Inpatient Rehabilitation Unit.
Assists in the screening process for potential candidates to the Rehabilitation Unit, ensuring patients meet admission criteria.
Attends team conferences to assess data for the IRF-PAI and assists in the development of the Individualized Plan of Care.
Learns and stays abreast of Medicare regulations for the Inpatient Rehabilitation Facility or Unit.
Responsible for the federal requirement of the 60% compliance rule reporting and tracking, and prepares the annual report for state submission.
Establishes and maintains excellent guest relations and customer service.
Serves as an expert on Federal Register requirements for payment through IRF-PAI submission.
Provides education on PPS system requirements to staff, physicians, coding, finance, and rehabilitation leadership.
Participates in performance improvement activities and assists in developing quality monitors and collecting data.
Runs reports from rehabilitation software for data analytics.
Completes and submits the IRF-PAI to ensure accurate payment and avoid penalties.
May obtain pre and re-authorization from payers as needed.
Performs other related duties as required and directed.