Working both autonomously and as part of the interdisciplinary team, the PPS Coordinator is responsible for the group process that produces an accurate IRF-PAI, then gathers the treatment team’s scores, validating them to the documentation in the official medical record.
The Prospective Payment System Coordinator will assign Impairment Group Codes in the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) with physician consultation as indicated. This position is responsible for coordination of data entry and data integrity in the IRF-PAI in Uniform Data System (UDS) and IRF-PAI transmission to CMS.
- Using clinical judgement, coordinates the accurate completion of IRF-PAI data into UDS. Works in collaboration with Program Directors to ensure clinical data is accurate in the IRF-PAI. This includes identification and communication of errors to Program Directors to support timely and ongoing education to staff.
- Collaborates with Medical Director and Program Directors to ensure correct Impairment Group Codes (IGCs) and inpatient diagnosis codes are assigned resulting in the correct CMG assignment for the UB-04. This includes verifying the principal diagnosis and the comorbidity codes.
- Helps ensure medical record integrity and compliance through medical record audits (as assigned).
- Pulls data related to the IRF-PAI and UDS for government and third party requests, quality improvement activities and accreditation activities.
- Provides ongoing education to IRF staff regarding Quality Indicators and assists with improving PEM scores and outcomes for patients.
- Other duties as assigned.
Education and Experience:
- RN, PT, OT or SLP
- Prospective Payment System Coordinator experience in an inpatient rehabilitation facility setting strongly desired