PPS Coordinator Inpatient Rehab- Sticht Center Winston Salem

The Inpatient Rehabilitation department at Atrium Health Wake Forest Baptist Sticht Center is seeking a full time PPS Coordinator to join the team. Qualified applicants must have a strong focus on team communication and organization flexibility and time management as well as data entry and analyzation. Candidates with experience in IRFPAI data management preferred but not required.

JOB SUMMARY: Manages the data collection systems for IRFPAI (Inpatient Rehabilitation Facility Patient Assessment Instrument) and IRFPPS (Medicare Inpatient Rehabilitation Facility Prospective Payment System. Responsible for the management of the eRehabdata outcomes measurement system. These responsibilities include ensuring accurate and timely collection and transmission of data collaborating with the interdisciplinary team to ensure complete and accurate documentation to support the data educating the interdisciplinary team on Care Tool and Quality Indicators (QI) to ensure accurate data and providing ongoing education to the interdisciplinary team related to the IRFPAI and eRehabdata systems and reports. This is a professional clinical position.

EDUCATION/EXPERIENCE: Bachelors degree in Nursing Physical Therapy Occupational Therapy or Speech Therapy with three years clinical/administrative experience in Inpatient Rehabilitation required.

LICENSURE CERTIFICATION and/or REGISTRATION: Credential Primary Source Verification required. Licensed in Nursing Physical Therapy Occupational Therapy or Speech Therapy by the State of North Carolina required. CPR certification required. MOAB (Management of Aggressive Behavior) certification required.

ESSENTIAL FUNCTIONS:

1. Assessment Admin Establishes and maintains a schedule for timely completion of all admission and discharge patient assessment instruments. Ensures completion of the patient assessment instrument and supporting documentation within established timeframes. Performs/oversees accurate entry and coding of data. Performs/oversees electronic data transmission to CMS and eRehabdata within established timeframes. Performs credentialing on the Care Tool and Quality Indicators as required by eRehabdata. Reviews admission and discharge assessment data and supporting clinical documentation to validate the data on the patient assessment instrument. Recognizes variances in documentation and collaborates with interdisciplinary team members to ensure accuracy of documentation.
2. Communication Communicates schedule for completion of patient assessment instruments to manager and billing department including CMG and date of transmission. Communicates expected Case Mix Group (CMG) and targeted length of stay based upon the admission patient assessment instrument to the interdisciplinary team at team conference.
3. Teamwork Collaborates with interdisciplinary team members to ensure accuracy of data. Provides clinical expertise by collaborating with members of the interdisciplinary team. Follows up with interdisciplinary team members as needed related to the accuracy or timeliness of documentation/data and provides feedback to manager as indicated. Provides feedback to interdisciplinary team members on the clinical and financial management of Medicare patients in particular. Attends team conferences to identify additional coding opportunities. Assists Admissions Coordinator with IRC referrals and admissions process as needed and serves as backup in his/her absence.
4. Billing Audits Completes quarterly billing audits to determine accuracy of dates of service and to ensure that what was billed matches the services provided.
5. Customer Focus Responsible for maintaining excellent rapport with all managed care company personnel and enhancing the work relationship as necessary. Communicates with managed care/insurance company personnel in a professional manner.
6. Compliance Keeps abreast of regulatory or other changes that impact the IRFPAI or eRehabdata outcomes management system. Demonstrates knowledge and understanding of CARF standards and assists management with ongoing CARF preparation as requested. Attends conferences on a regular basis to ensure continued compliance with regulatory requirements coding and billing requirements and FIM requirements. Completes quarterly documentation audits to ensure compliance with regulatory requirements.
7. Reporting Independently manipulates eRehabdata outcomes management system to regularly generate and retrieve routine and ondemand reports for manager/director in order to assist in supporting decision making process improvement etc. Analyzes report information and identifies trends. Makes recommendations for process improvements as indicated.
8. Training & Education Provides ongoing education to interdisciplinary team on the IRFPAI and eRehebdata outcomes management system including providing inservices as needed to clarify issues or address variances and providing oneonone coaching to improve the quality of data to maximize reimbursement and ensure accurate documentation of outcomes. Provides orientation on the IRFPAI and the eRehabdata outcomes management system to all new employees. Provides for staff training on the IRFPAI Care Tool and QI as required by eRehabdata.
9. Professionalism Upholds a professional working relationship at all times and adheres to department rules. Practices teamwork and adheres to Standards of Behavior.
10. Performs other duties as assigned by management.