Rehab Coordinator

Stamford Health•Stamford, CT

13d

About The Position

This role focuses on managing Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) data, ensuring quality and safety measurement, conducting chart and coding reviews, fostering interdisciplinary collaboration, supporting audit and compliance efforts, and providing education and training to clinical staff. The coordinator will be responsible for accurate data submission, analysis of quality metrics, and ensuring compliance with CMS regulations.

Requirements

Knowledge of IRF-PAI data definitions, coding rules, and submission guidelines.
Ability to collect, enter, analyze, and transmit clinical data.
Understanding of Medicare PPS requirements.
Skills in medical record review and coding.
Familiarity with quality measures and patient outcomes.
Knowledge of CMS requirements, including the 60% rule and 3-hour rule.
Ability to prepare for audits and medical reviews.
Proficiency in educating clinical staff on documentation and scoring.
Ability to maintain continuing education and professional development.

Nice To Haves

Experience with Section GG.
Collaboration with coding and revenue cycle teams.
Participation in interdisciplinary rounds and team conferences.
Assistance with patient screening for rehabilitation appropriateness.
Backup support for admissions coordination.
Monitoring of IRF metrics (LOS, Case Mix Index, ADC, CMGs).
Support for Utilization Review processes and regulatory survey readiness.
Tracking of regulatory updates.

Responsibilities

Complete, encode, and submit IRF-PAI assessments and CMS Quality Indicators (e.g., Section GG) within required timeframes.
Collect, enter, analyze, and transmit clinical data in compliance with Medicare PPS requirements.
Ensure accuracy and completeness of all data submitted for CMS reimbursement.
Maintain current knowledge of IRF-PAI data definitions, coding rules, and submission guidelines.
Support abstraction, analysis, and reporting of clinical quality measures for internal and external programs.
Monitor performance metrics and identify trends in quality and patient outcomes.
Conduct data audits to ensure accuracy, completeness, and regulatory compliance.
Assist with quality improvement initiatives and reporting requirements.
Perform concurrent medical record reviews to assign appropriate Impairment Group Codes (IGC), etiologic diagnoses, and comorbidities.
Collaborate with coding and revenue cycle teams to ensure accurate reimbursement.
Monitor documentation to support coding accuracy and regulatory compliance.
Partner with physicians, therapists, nursing, and case management to ensure documentation reflects patient severity and care needs.
Participate in interdisciplinary rounds and team conferences to support care planning and length-of-stay (LOS) management.
Assist with patient screening for rehabilitation appropriateness.
Provide backup support for admissions coordination as needed.
Monitor key IRF metrics (e.g., LOS, Case Mix Index, ADC, CMGs).
Ensure compliance with CMS requirements, including the 60% rule, 3-hour rule, and documentation standards.
Prepare for audits, medical reviews, and Additional Documentation Requests (ADRs).
Support Utilization Review processes and regulatory survey readiness.
Track regulatory updates and ensure adherence to current standards.
Educate clinical staff on CMS documentation requirements, IRF-PAI scoring, and PPS guidelines.
Provide ongoing training on quality measures and rehabilitation program metrics.
Support staff competency in regulatory and documentation standards.
Maintain required continuing education and professional development.
Perform other duties as assigned to support departmental and organizational goals.