PPS Coordinator

Essential Job Responsibilities 

​​Inpatient Rehabilitation Facility – Patient Assessment Instrument (IRF-PAI) 

• ​Completes the IRF-PAI data which determine a patient’s RIC (Rehabilitation Impairment Category), CMG (Case Mix Group), and payment under the Rehabilitation Perspective Payment system. 

• ​Develops and implements a schedule for completion of IRF-PAI according to Medicare requirements. 

• ​Assures accuracy and thoroughness of data recorded. 

• ​Coordinates the pre-admit assessment and screening process for patients in conjunction with the Admission Coordinators, Physicians and Coders. 

• ​Comprehensively assesses the data gathered for the IRF-PAI and contributes to the development of the plan of care. 

• ​Coordinates and completes the PAI on all other acute rehabilitation inpatients as part of the hospital outcomes tool. 

• ​Works directly with the inpatient coding staff to properly identify and document all applicable codes on a concurrent basis. 

​Functional Independence Measure (FIM) -  Education and Resource 

• ​In collaboration with the clinical leadership team and the PPS Process Specialist, assists necessary training for clinical employees that are responsibility for FIM evaluation and documentation. 

• ​Through regular audits, evaluates documentation of clinical team members and provides timely feedback when opportunities for improvement are identified. 

• ​Maintains communication with leadership team members when repeated documentation concerns are identified. 

​Medicare Documentation Requirements 

• ​As assigned by the PPS Process Specialist, the PPS Program Coordinator serves as a clinical resource for PPS regulations and compliance, coding and billing related to the IRF-PAI, and CMS documentation requirements. 

• ​In collaboration with the PPS Process Specialist, provides physician and clinical staff education regarding regulatory requirements. 

• ​Provides direct and timely feedback to physicians when required components of documentation are not present, and provides suggestions for improvement. 

• ​Assists with development of a comprehensive, integrated patient plan of care, as required by CMS. 

• ​In collaboration with the PPS Process Specialist, stays abreast of regulatory and accreditation changes that impact the rehabilitation industry. 

• ​In collaboration with the PPS Process Specialist, observes and analyzes systems through regular audits to enhance systems efficiencies and conducts quality assurance activities. 

• ​Physician Relations – Maintains effective working relationships with the inpatient rehabilitation medical directors and other physicians that provide care to the patients served. 

• ​Staff Development and Mentoring – Assists the PPS Process Specialists with leadership for the entire PPS program, including ongoing staff development and mentoring of other PPS team members.  Encourages staff development through formal and informal learning opportunities. 

• ​Professional Work Environment - Encourages a culture of personal accountability, solution-seeking behavior, and mutual respect, timely communication, openness to change, enthusiasm, and pride. 

• ​Interdepartmental and Interdisciplinary Collaboration - Promotes collaboration within all disciplines within the inpatient rehabilitation unit, and with other departments and institutions.  Works to effectively integrate all members of the patient care team to provide outstanding rehabilitation services 

• ​We’ll embrace all people by: 

• ​Treating everyone with dignity and respect. 

• ​Opening more doors to opportunity for others to succeed. 

• ​Growing talent and people. 

• ​Ensuring a welcoming experience for all we serve, regardless of origin, race, religion, disability, sexual orientation or socioeconomic status. 

• ​Taking action against discrimination. 

• ​Honoring our differences and how we collaborate. 

• ​Educating staff, patients and the communities we care for. 

• ​Restoring hope and freedom, together. 

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Customer Service Responsibilities 

Demonstrate excellent customer service and standards of behaviors as well as encourages, coaches, and monitors the same in team members. This individual should consistently promote teamwork and direct communication with co-workers and deal discretely and sensitively with confidential information. 

Responsibilities in Quality Improvement 

Contribute by identifying problems and seeking solutions. Promote patient/family satisfaction where possible; participates in departmental efforts to monitor and report customer service. 

Essential Job Qualifications 

Education:  Associates degree required. Bachelor’s degree preferred.  

Experience:  

• A minimum of two years of relevant clinical experience and direct experience with the Inpatient Rehabilitation Prospective Payment System (PPS) process. 

Skills and Attitude: 

• Demonstrated excellent written and verbal communication skills. 

• Information management skills to communicate, explain, interpret, and present data. 

• Demonstrated ability to work both independently and in conjunction with a team of professionals for problem solving. 

• Sense of urgency, collaborative team style, and ability to quickly adapt to changes in priorities. 

• Ability to multi-task and delegate tasks for timely project completion. 

• Demonstrated commitment to the organizational mission with a “whatever it takes” attitude to get the job done.