RN - PPS Coordinator/ Case Manager

Community Health Systems Professional Services Corporation•Natchez, MS

About The Position

The Medicare IRF PAI Coordinator ensures the accuracy and completeness of patient documentation to support compliance with CMS guidelines for admission, assessment, and reimbursement within an Inpatient Rehabilitation Facility (IRF). This role manages the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI), coordinates interdisciplinary input, and ensures timely transmission of data to CMS. The Coordinator also provides training and education to staff on IRF documentation standards and regulatory updates.

Requirements

Associate Degree in Nursing, Therapy, Health Information Management, or related field required
RN - Registered Nurse - State Licensure and/or Compact State Licensure in state of Tennessee or compact state required
BCLS - Basic Life Support required
ABLS - Advanced Burn Life Support required
In-depth understanding of CMS IRF-PAI guidelines and regulatory requirements.
Knowledge of medical terminology, coding, and clinical documentation improvement.
Strong organizational and time management skills to meet regulatory deadlines.
Ability to communicate effectively with clinical and non-clinical staff.
Proficiency with rehabilitation software systems (e.g., UDS) and EMR platforms.
Strong attention to detail and critical thinking skills.
Ability to deliver education and facilitate training for interdisciplinary teams.

Nice To Haves

Bachelor's Degree in a healthcare-related field preferred
2-4 years of experience in inpatient rehabilitation or medical record review preferred
1-2 years of experience with IRF-PAI completion and CMS documentation standards preferred

Responsibilities

Reviews patient medical records to ensure documentation supports CMS requirements for IRF admission and reimbursement.
Completes and submits the IRF-PAI accurately and on time, coordinating with interdisciplinary team members to gather required data.
Assigns IRF-PAI sections to appropriate team members, monitors completion timelines, and resolves discrepancies in assessment scoring.
Transmits IRF-PAI data to CMS via appropriate systems (e.g., UDS) and ensures alignment with CMS coding and documentation standards.
Audits medical record documentation and coding for accuracy, collaborating with coding and clinical teams to address inconsistencies.
Educates staff and physicians on IRF-PAI requirements, scoring methodology, CMS updates, and documentation best practices.
Assists with onboarding and training of new team members on IRF processes and assessment standards.
Participates in internal audits, quality improvement initiatives, and compliance activities related to IRF standards.
Maintains confidentiality in accordance with HIPAA and represents the facility professionally in all interactions.
Performs other duties as assigned.
Maintains regular and reliable attendance.
Complies with all policies and standards.