PPS (Prospective Payment System) Coordinator, Acute Rehab RN
About The Position
The PPS (Prospective Payment System) Coordinator plays a vital role in the management and optimization of reimbursement for inpatient rehabilitation services. This position is responsible for ensuring compliance with CMS regulations, monitoring clinical documentation for accuracy and completeness, and working collaboratively with the interdisciplinary team to support quality outcomes and appropriate reimbursement under the prospective payment system. The ideal candidate is a clinically experienced registered nurse with an acute care background and a strong commitment to collaboration, quality improvement, and regulatory compliance.
Requirements
- Licensure: Active and unencumbered Registered Nurse (RN) license in the state of Arkansas.
- Experience: Clinical RN experience in an acute care or inpatient rehabilitation setting.
- Strong organizational, communication, and analytical skills are essential.
- Attention to detail and strong analytical thinking.
- Proven teamwork and interpersonal skills with a collaborative mindset.
- Ability to manage multiple priorities in a fast-paced environment.
- Strong Communication Skills: Demonstrates the ability to confidently and effectively share information with colleagues and leadership.
- Commitment to professional integrity and confidentiality in handling sensitive data.
Nice To Haves
- Prior experience with IRF PPS, MDS, or ICD-10 coding preferred
- Knowledge of CMS QRP (Quality Reporting Program) and IRF documentation standards strongly preferred.
Responsibilities
- Coordinate all PPS-related processes including data collection, scoring, and submission of the IRF-PAI in accordance with CMS guidelines and timelines.
- Ensures documentation accurately supports the data submitted
- Conducts ongoing review of IRF PAI related data, and assists the Director to address action.
- Conducts regular audits and provide feedback to the team on GG scoring, rating, and quality measures.
- Provide clinical staff education to ensure compliance with CMS guidelines
- Facilitate interdisciplinary communication and problem-solving related to PPS processes and documentation concerns.
- Provides guidance to rehab physicians and clinical team on capturing tier codes for appropriate reimbursement.
- Monitor and report key metrics to leadership.
- Collaborate with the HIM/coding department to ensure real-time documentation and code assignment.
- Assist IPR leadership in the development of quality improvement initiatives informed by data trends and audit results.
- Maintain up-to-date knowledge of Medicare rules and IRF compliance requirements.
- Support occasional clinical care activities as needed within nursing licensure scope.
- Perform other related duties as assigned to support departmental and facility goals.
Benefits
- Competitive salary and benefits
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
