Prospective Payment System Coordinator - PRN

INTEGRIS Health

5d•Onsite

About The Position

The Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) Coordinator/PPS Coordinator is a finance-related position requiring clinical skills to coordinate the process of providing accurate and timely data to the appropriate entities involved in the Prospective Payment System for inpatient rehabilitation patients. The IRF-PAI Coordinator oversees all aspects of data collection on the IRF PAI, ensures the presence of supporting documentation and provides staff education to ensure compliance with CMS guidelines. Responsible for coordinating all patient information to be submitted to CMS for Medicare reimbursement. Responsible for Utilization Review to maximize LOS efficiency. Coordinate and monitor compliance with 60% rule. Responsible for monitoring patient charts for correct coding and electronically transmitting data in a timely manner to maximize reimbursement. Monitor program compliance with charging for Medicare Services (CMS). In addition, this position participates with staff orientation and ongoing education to improve functional scoring accuracy at admission, throughout the stay, and upon discharge. Serves as a resource to licensed clinicians and clinical staff regarding questions and interpretation of scoring guidelines to assure the accuracy of scores.

Requirements

Clinical skills
Accurate and timely data provision
Knowledge of Prospective Payment System for inpatient rehabilitation patients
Understanding of IRF PAI data collection
Ability to ensure supporting documentation
Staff education on CMS guidelines
Coordination of patient information for CMS submission
Utilization Review skills
Monitoring compliance with 60% rule
Monitoring patient charts for correct coding
Electronic data transmission
Monitoring program compliance with CMS charging
Staff orientation and ongoing education
Resource for clinicians on scoring guidelines

Responsibilities

Oversees all aspects of data collection on the IRF PAI.
Ensures the presence of supporting documentation.
Provides staff education to ensure compliance with CMS guidelines.
Coordinates all patient information to be submitted to CMS for Medicare reimbursement.
Responsible for Utilization Review to maximize LOS efficiency.
Coordinates and monitors compliance with 60% rule.
Monitors patient charts for correct coding and electronically transmits data in a timely manner to maximize reimbursement.
Monitors program compliance with charging for Medicare Services (CMS).
Participates with staff orientation and ongoing education to improve functional scoring accuracy at admission, throughout the stay, and upon discharge.
Serves as a resource to licensed clinicians and clinical staff regarding questions and interpretation of scoring guidelines to assure the accuracy of scores.