About the position
Responsible for the timely preparing, filing, and tracking required Center for Medicare and Medicaid Services (CMS) documents for all Medicare patients on the Transitional Care Unit and oversees all aspects of data collection on the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI).
Responsibilities
- Documents clinical assessment of patients and sends electronically to the Center for Medicare and Medicaid Services (CMS) in mandatory specified time frames.
- Responsible for clinical data collection, entry, transmission, and analysis to ensure compliance with the requirements of the Medicare Prospective Payment System.
- Provides on-going education to physicians, nursing staff, ancillary staff, and support staff regarding CMS, state, and other regulatory agencies.
- Provides periodic and on-going Functional Independence Measure (FIM) training for nurses, therapist, and physicians; provides training for mandatory FIM credentialing by rehabilitation clinicians.
- Maintains current knowledge of Resident Assessment Instrument (RAI) Manual and Minimum Data Set (MDS) assessment process.
- Monitors completion of MDSs by other disciplines within time frames prescribed by regulatory guidelines.
- Performs IRF-PAI data collection and review for completeness, accuracy, consistency, and reliability.
- Assists in the development of a comprehensive resident assessment and care plan.
- Utilizes critical thinking skills to select the correct reason for assessment and Assessment Reference Date (ARD); participates in the minute management process.
- Monitors patient charts for correct coding, electronically transmits data, and communicates with a multidisciplinary team to create and carry out patient treatment plans.
- Monitors and audits clinical record documentation on assigned residents to ensure accuracy and timeliness.
- Monitors program compliance and changes with Medicare Services.
- Coordinates the development and completion of the resident assessment MDS for all residents assigned in accordance with all federal and state guidelines.
- Coordinates the process of providing accurate and timely data to the appropriate entities involved in the Prospective Payment System for Medicare patients.
- Coordinates all patient information to be submitted to CMS for Medicare reimbursement.
- Ensures that the care/services provided are captured accurately and appropriate payment is received by the Medicare/Medicaid systems.
- Ensures that admission, weekly, and discharge FIM scores are documented in the medical record and available for weekly Team Conferences.
- Selects the correct ARD and correct reasons for assessment that capture all resources to ensure appropriate payment by Medicare/Medicaid systems.
- Successful completion of functional assessment training and testing.
Requirements
- Bachelor's degree or higher in Nursing required within 5 years of employment in this position.
- A minimum of 2 years' relevant experience required.
- RN - Licensed as a Registered Nurse. Eligible to practice nursing in the State of Kentucky required upon hire.
