PPS Program Coordinator

Mary Free Bed Rehabilitation Hospital•Traverse City, MI

13d•Onsite

About The Position

The PPS Program Coordinator is responsible for assigned aspects of the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) Program at Mary Free Bed at Munson. The PPS Program Coordinator is responsible for training and ongoing collaboration with members of the treatment team that are involved in patient assessment and data reporting. The PPS Program Coordinator works with physicians and coders to assure data is encoded and transmitted in accordance with Medicare guidelines and those requirements of other payors. The PPS Program Coordinator participates in staff education and quality assessment/improvement activities related to the IRF-PAI process. The person in this role will also assist members of the leadership team to develop thorough documentation systems for all disciplines that reflect the complex nature of inpatient rehabilitation care, and that comply with Medicare guidelines.

Requirements

RN, PT, OT or ST License
A minimum of two years of relevant clinical experience and direct experience with the Inpatient Rehabilitation Prospective Payment System (PPS) process.
Demonstrated excellent written and verbal communication skills.
Information management skills to communicate, explain, interpret, and present data.
Demonstrated ability to work both independently and in conjunction with a team of professionals for problem solving.
Sense of urgency, collaborative team style, and ability to quickly adapt to changes in priorities.
Ability to multi-task and delegate tasks for timely project completion.
Demonstrated commitment to the organizational mission with a “whatever it takes” attitude to get the job done.

Nice To Haves

Bachelor’s degree in clinical profession preferred – RN, PT, OT or ST.

Responsibilities

Completes the IRF-PAI data which determine a patient’s RIC (Rehabilitation Impairment Category), CMG (Case Mix Group), and payment under the Rehabilitation Perspective Payment system.
Develops and implements a schedule for completion of IRF-PAI according to Medicare requirements.
Assures accuracy and thoroughness of data recorded.
Coordinates the pre-admit assessment and screening process for patients in conjunction with the Admission Coordinators, Physicians and Coders.
Comprehensively assesses the data gathered for the IRF-PAI and contributes to the development of the plan of care.
Coordinates and completes the PAI on all other acute rehabilitation inpatients as part of the hospital outcomes tool.
Works directly with the inpatient coding staff to properly identify and document all applicable codes on a concurrent basis.
Serves as the trainer and resource for the QRP scoring process for all direct care staff.
Develops and implements QRP scoring competency testing for all direct care staff.
Responsible for New Hire direct care staff QRP scoring education and competency.
Through regular chart audits, determines areas for QRP focused education for accuracy.
Communicates with the Supervisor of PPS Compliance when repeated QRP documentation concerns are identified.
Maintains current knowledge of the QRP scoring process by attending National Education for current practice.
Assures accuracy of QRP and other data entered.
As assigned by Inpatient Rehab Leadership, the PPS Program Coordinator serves as a clinical resource for PPS regulations and compliance, coding and billing related to the IRF-PAI, and CMS documentation requirements.
In collaboration with Inpatient Rehab Leadership, provides physician and clinical staff education regarding regulatory requirements.
Provides direct and timely feedback to physicians when required components of documentation are not present and provides suggestions for improvement.
Assists with development of a comprehensive, integrated patient plan of care, as required by CMS.
In collaboration with Inpatient Rehab Leadership, stays abreast of regulatory and accreditation changes that impact the rehabilitation industry.
In collaboration with Inpatient Rehab Leadership, observes and analyzes systems through regular audits to enhance systems efficiencies and conducts quality assurance activities.
Maintains effective working relationships with the inpatient rehabilitation medical directors and other physicians that provide care to the patients served.
Assists leadership in Inpatient Rehabs with leadership for the entire PPS program, including ongoing staff development and mentoring of other PPS team members.
Encourages staff development through formal and informal learning opportunities.
Encourages a culture of personal accountability, solution-seeking behavior, and mutual respect, timely communication, openness to change, enthusiasm, and pride.
Promotes collaboration within all disciplines within the inpatient rehabilitation unit, and with other departments and institutions.
Works to effectively integrate all members of the patient care team to provide outstanding rehabilitation services.
Works closely with billers and UM to ensure accuracy of claims information.
Monitors post payment denials and appeals, working collaboratively to address issues.
Demonstrate excellent customer service and standards of behaviors as well as encourages, coaches, and monitors the same in team members.
This individual should consistently promote teamwork and direct communication with co-workers and deal discretely and sensitively with confidential information.
Contribute by identifying problems and seeking solutions.
Promote patient/family satisfaction where possible; participates in departmental efforts to monitor and report customer service.