PT/OT/SLP/RN Clinical PPS Coordinator, Full-time

JOB SUMMARY:  

Reporting to the PPS and HIMS Manager, the IRF PPS Coordinator will collect the data on the Inpatient Rehabilitation Facility Patient Assessment instrument (IRF-PAI) by ensuring the presence of supporting documentation in the legal medical record and the accuracy of patient functional scores. The coordinator will provide staff with any updates on quality reporting by CMS as it pertains to the IRFPAI. The coordinator will serve as an information source and educate about IRFPAI items. When needed the coordinator will assist department leads and educators with staff training. The coordinator will serve as a backup to uploading the IRFPAI into eRehab and the transmission of the IRFPAI through the IQIES portal. The coordinator will work along a team that is dedicated to fulfilling department and organizational goals. 

WORK PERFORMED:

•  Maintain current and comprehensive knowledge of IRF Prospective payment system (PPS), Federal and State regulations, and industry standards
• Responsible for accurate and timely completion of Inpatient Rehabilitation Facility – Patient Assessment Instruments (IRF-PAIs) according to CMS IRF-PAI Manual, published CMS IRF-PAI Quarterly Q&A clarifications to existing guidance, and applicable rules and regulations
• Review and populate daily compliance reports in Epic to monitor and manage IRF-PAIs completion within CMS assigned timeframes
• Act as a liaison between the rehabilitation team (therapy, nursing), rehabilitation physicians, and other departments (Pre-admission screening, billing departments, Coding services, etc.) 
• Responsible for monitoring 60% compliance rule for rehabilitation admissions
• Communicate CMG information and ELOS with rehabilitation physicians and rehabilitation teams along with providing education. 
• Perform periodic audits of records and give feedback to the Department Manager and VP of Post-acute Services
• Monitor accuracy of the Impairment group codes and ICD-10 coding of the IRF-PAIs
• Assist with uploading and validating the IRF-PAIs in eRehab and transmitting to CMS
• Review on admission that all clinical documentation and scores are gathered within the three days of admission to reflect a three-day summary of functional status and 24-hour care needs of the patient
• Review clinical documentation throughout and more importantly 72 hours prior to discharge to ensure all required items are entered
• Serve as an information source and educator, provide ongoing education, in conjunction with the department leads and educators, to the staff of the hospital, including GG items, quality reporting

 OTHER:

• Practices Standard Precautions. Follows regulations, policies and guidelines on the prevention of infections; does not eat or drink in patient care areas.
• Demonstrates personal adherence to the corporate compliance program and related activities.
• Attending GG task force meeting. 
• Attend educational events provided by eRehab.
• Maintains confidentiality of information; abides by HIPAA regulations.
• Maintains a professional image and follows Hospital’s policy on uniforms; consistently wears hospital ID.
• Demonstrates reliable, on-time attendance, which is an essential function of all jobs at Burke.
• Completes mandatory annual learning (Learning Harbor) within deadline.
• Personally adheres to Burke C.A.R.E.S. philosophy by demonstrating compassion, accountability, respect and exceeding expectations through service excellence.
• Performs other job related duties as assigned.

 Requirements:         

• NYS License and current registration required. Registered Nurse, Physical Therapist, Occupational Therapist, Speech Pathologist.
• Experience with Inpatient Rehabilitation Quality Indicators.
• EPIC EMR experience.
• E-Rehab data experience .
• Clinical experience in inpatient rehabilitation setting preferred.
• Preferably experience with knowledge of ICD-10 coding.
• Must be able to communicate effectively, verbally and in writing with all levels of hospital staff, third-party payers, and external contacts. 
• Must have Knowledge of the rehabilitation process, medical terminology, and overall understanding of the healthcare system. 
• Must be able to work independently with minimal supervision.