What are the responsibilities and job description for the PPS CLINICAL COORDINATOR position at Villa Maria Nursing Ctr & Rehab?
Description
Summary & Objective
The Coordinator, PPS is responsible for planning, developing and overall coordination of activities that support the Prospective Payment System (PPS) process for the inpatient rehabilitation unit. Assists the Interdisciplinary Rehabilitation Team to assure the comprehensive assessments of patients’ through utilization and completion of the PAI and other assessment tools in accordance with requirements of regulatory agencies. Interfaces with the Interdisciplinary Rehabilitation Team to assure accuracy, completeness and transmission of findings and assumes total responsibility for the PAI process.
Essential Functions
- Collects data for all IRF patients and accurately completes the IRF-PAI (Inpatient Rehabilitation Facility-Patient Assessment Instrument) and transmits Medicare/Managed Medicare data to CMS in a timely manner.
- Communicates and collects data from the different disciplines: Medical Director, Physical Therapy, Occupational Therapy, Speech Language Pathology and Nursing to properly complete the IRF-PAI.
- Assigns and inputs ICD-10 codes for all admitting diagnosis and comorbid conditions for all patients admitted to facility.
- Communicate with Physicians and clinical staff to improve and/or correct medical documentation.
- Complete and properly transmit IRF-PAI data to CMS within the regulatory time frame guideline.
- Send CMS validation report CHS Finance Department to ensure proper billing and reimbursement.
- Provides education to all clinical disciplines to ensure proper FIM (Functional Independent Measurements) score ratings.
- Prepare daily, weekly, monthly and/or quarterly reports for Director, Executive / Administrator and/or CHS.
- Monitor and ensure facility is in compliance with: 60% rule, 3 hours therapy guideline and appropriateness of patient within the established timeframe.
- Meets with Administrator to discuss escalated matters, obtain direction and set time frames for planned activities.
- Participates in daily, weekly and/or monthly management team meetings to discuss patients and/or resident’s status, financial obligation, census changes, or patient and/or resident’s complaints or concerns.
- Participate in weekly Performance Improvement meeting with all involved disciplines.
- Participate in weekly clinical rounds if applicable.
- Complete UDSMR (Uniform Data System for Medical Rehabilitation Hospital) Credentialing process as required.
*Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.
Other Duties
- Promotes positive employee engagement, teamwork, and mutual respect and safety work practices.
- Maintain your required certifications and mandatory skill updates.
- Comply with all policies, local, state and federal laws and regulations.
- Perform other duties as assigned.
Supervisory Responsibility
- May serve as an interim department leader depending on need
Requirements
Physical Requirements
- Must be able to lift and/or move up to 50 pounds and push/pull up to 250 pounds, walk, climb stair or ladders, stand on feet for extended periods of time, etc.
