Sparrow Health System
Sparrow Mary Free Bed Inpatient Rehab
Positions Location: Lansing, MI
General Purpose of Job:
The Rehab Service Line PPS Coordinator will plan, organize, direct and evaluate the Acute Rehabilitation Medicare Prospective Payment System Process. This includes assignment of the CMG for each Medicare fee for service patient with expected Medicare reimbursement. In addition, oversees the coordination of the documentation, recording, data entry, data transmission, and analysis of the required Inpatient Rehabilitation Facility – Patient Assessment Instrument (IRF-PAI) Items, CMG, assignment, identification of allowable co-morbidities, and the IRF-PAI assessment schedule.
This job description is intended to cover the minimum essential duties assigned on a regular basis. Associates may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.
- Timely and accurate completion and submission of the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF/PAI) to CMS.
- Demonstrates knowledge of CMS regulations, clinical documentation requirements and referral policies and procedures. In addition, tracks changes in CMS rules and regulations.
- Performs reviews of patient medical records to verify supportive documentation for the IRF/PAI and CMS Medical Necessity.
- Assists, when needed, in pre-admission screening and referral process and participates in pre-admission education of patients admitted from within the institution.
- Serves as primary resource and educator to hospital and medical staff regarding documentation, compliance, coding and reimbursement, and performance improvement opportunities.
- Monitors and reports PPS related outcomes, trends, opportunities.
- Communicates with Coding staff/H.I.M. to provide information and guidance to achieve consistently appropriate diagnoses and co-morbidities along with physician guidance in decision-making process.
Organizes and facilitates process for maintaining staff FIM education and credentialing.
Current Michigan RN, PT, OT, SLP, PTA, or COTA licensure
- Minimum of five-years recent experience in rehabilitation nursing.
- Previous PPS Coordinator experience preferred
- Graduate of an accredited nursing, physical therapy, occupational therapy, speech therapy, physical therapy assistant or occupational therapy assistant program.
Specialized Knowledge and Skills
- Clinical knowledge and analytical abilities necessary to apply Medicare guidelines in a clinical setting.
- Interpersonal skills to effectively and appropriately communicate with patients, families, physicians, other Sparrow Health System Associates, and external agencies.
- Basic computer skills needed along with the ability to learn new software programs.
- Requires excellent observation and problem solving skills.
- Excellent verbal and written communication skills.
- Must be able to adhere to deadlines in a detail-oriented manner.
- Must possess excellent organizational skills and the ability to work independently without supervision.
Sparrow Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.
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