What are the responsibilities and job description for the Prospective Payment System (PPS) Coordinator position at Keck Medical Center of USC?
The PPS Coordinator reports to the Director of the Acute Rehab Unit 3 North and is responsible for assisting the director with meeting facility and CMS IRF regulatory standards. PPS Coordinator assumes the primary role to complete each IRF-PAI form completely, accurately and timely. Main duties include 1) collecting, reviewing and monitoring the information contained in the IRF-PAI, on each patient to ensure accuracy in the scoring of functional status and clearly reflect the status of the patient and their patient care needs, as documented in the medical record and the UDS Pro-Doc system, in collaboration with the interdisciplinary team. 2) Coordinates the IRF-PAI processes with various hospital departments to ensure timely billing and assures that final IRF CMG codes are accurate; 3) Analyzes -Quality Indicators for accuracy and work with interdisciplinary team to appropriately query nurses, therapist and clinicians for discrepancies.4) Transmits IRF-PAI data in a timely manner consistent with CMS regulations; 5) Maintaining a recognized area of expertise in IRF regulatory standards and applies it in practice, teaching and consultation. 5) Demonstrates problem solving, critical thinking and communication skills, along with an advanced knowledge in constructing action plans and follow up for areas identified as opportunities to improve or from recommendations for improvement from Inpatient Rehabilitation Facility (IRF) regulatory agencies.
Minimum Education: Bachelor’s Degree Nursing BSN or higher in nursing or other allied health profession. Minimum Experience: 2 years Minimum two (2) years’ experience in an inpatient rehab setting OR in the field of rehab case management. Experience with FIMS and IRF-PPS Experience with and knowledge of Medicare, UDS, IQIES, and insurance industry requirements, as well as rehab coding. Required Certifications: Registered Nurse - RN (CA Board of Registered Nursing) Current state licensure in nursing (RN) or allied health profession (PT, OT); Others considered based on experience. Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire, and maintained by renewal before expiration date. (Required within LA City only)
