Prospective Payment System Coordinator-PD

Catholic Health•Port Jefferson, NY

32d•Onsite

About The Position

The Prospective Payment System (PPS) Coordinator, also known as the IRF Prospective Payment System Coordinator, collaborates with the Director of Rehab Admissions and the inpatient rehabilitation team to ensure compliance with Centers for Medicare and Medicaid Services (CMS) regulatory requirements. The primary responsibility of the PPS Coordinator is the accurate and timely completion and submission of the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) for every inpatient rehabilitation patient. This involves consistent communication with the inpatient rehabilitation interdisciplinary team, collecting and submitting data for all CMS Quality Indicators, and documenting patient functional status on the IRF-PAI. Additionally, the PPS Coordinator supports the Rehab Admissions department by reviewing electronic medical records (EMR) to identify potential candidates for acute rehabilitation. The role also includes monitoring identified benchmarks for the inpatient population and providing ongoing clinical staff education to the interdisciplinary rehabilitation team. The PPS Coordinator will have access to confidential patient, employee, and organizational information and is responsible for maintaining its confidentiality.

Requirements

Completion of an appropriate clinical profession degree (RN, PT, OT, SLP, MSW)
RN (Associates or Bachelors), PT (Bachelors, Masters or DPT), OT (Bachelors or Masters), SLP(Masters) or LMSW(Masters)
Maintains clinical license/ certification in the state of New York
Minimum of 3 years of experience in inpatient rehabilitation
Intermediate computer skills in Microsoft Word and Excel
Ability to handle multiple priorities
Strong attention to detail and organizational skills
Strong interpersonal skills
Ability to coordinate efforts within a multi-disciplinary team

Responsibilities

Utilizes UDSpro software to complete and submit an IRF-PAI for all patients admitted to the Inpatient Rehab program.
Monitors utilization and keeps the clinical team apprised of expected length of stay relative to the patient’s CMG assigned by CMS.
Assists the DPM&R, Director of Rehab Admissions, nursing, therapy and other appropriate departments in identifying and monitoring trends in inpatient care and program efficiency as identified through UDSmr reports.
Works closely and collaboratively with all members of the inpatient rehab team to assure compliance at all levels.
Performs EMR reviews to monitor required documentation and provide feedback to appropriate supervisors.
Responsible for training clinical staff on the appropriate use of the CMS assessment tools and other documentation requirements.
Support Rehab Admissions to identify candidates that meet criteria for inpatient rehab through EMR reviews.
Support Rehab Admissions with maintaining updated referral database.
Participates with inpatient rehab department to revise and update documentation for CMS compliance, good patient care and best practice.