PPS (Prospective Payment System) Coordinator, Acute Rehab RN

Signet Health; Hickory (NC); On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Comprehensive benefits

Job summary

Signet Health seeks a Prospective Payment System (PPS) Coordinator for the acute rehabilitation program at Catawba Valley Medical Center in Hickory, NC. The role leads reimbursement data collection and IRF-PAI submission to CMS, and educates clinical staff to ensure CMS compliance.

Minimum two years rehabilitation experience is required; NC RN or allied health licensure is needed. The position collaborates with HIM coding and leadership on performance metrics.

Qualifications

• CMS data collection and IRF-PAI familiarity required.
• Minimum two years of rehabilitation experience.
• Experience with MDS, IRF-PAI, UDS; CMS guidelines knowledge.
• ICD-10 coding experience preferred.

Responsibilities

• Coordinate data collection on IRF-PAI for CMS submission.
• Ensure supporting documentation is available.
• Provide clinical staff education to ensure CMS compliance.
• Coordinate efforts for issue resolution regarding GG scoring.
• Review IRF-PAI data and assist the Director to address actions.
• Guide rehab physicians and team on tier codes for reimbursement.
• Provide audit feedback on scoring, rating, and quality measures.
• Implement a schedule for timely IRF-PAI completion.
• Report key metrics to leadership at daily meetings.
• Collaborate with HIM coding to document applicable codes.

Skills

CMS data collection

IRF-PAI knowledge

Clinical staff education

Documentation & coding awareness

Education

NC RN licensure

Allied health licensure (PT/OT/SLP)

Tools

ICD-10 coding

MDS

IRF-PAI software

Job description

Overview

Prospective Payment System Coordinator

Acute Inpatient Rehabilitation

Catawba Valley Medical Center

Hickory, North Carolina

Signet Health, a national acute rehabilitation and behavioral health company is seeking a Prospective Payment System (PPS) Coordinator for the acute rehabilitation program at Catawba Valley Medical Center in Hickory, NC.

The PPS Coordinator is responsible for the management and optimization of reimbursement for inpatient rehabilitation services for the Signet Health Client hospital contractual relationship. Included in these responsibilities are:

• Coordinates the data collection on the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) for completion and timely submission to CMS.
• Ensures evidence of supporting documentation.
• Provides clinical staff education to ensure compliance with CMS guidelines.
• Coordinates all efforts for immediate issue resolution concerning GG scoring and rating.
• Conducts ongoing review of IRF-PAI related data and assists the Director to address action.
• Provides guidance to rehab physicians and clinical team on capturing tier codes for appropriate reimbursement.
• Provides feedback to the team through audits on scoring, rating, and quality measures.
• Implements a schedule for every patient for timely completion of the IRF-PAI.
• Reports key metrics to the leadership team at daily team meetings.
• Participates in IDT meetings and provides updates regarding assessment completion and compliance concerns.
• Collaborates closely with HIM coding department to identify and document all applicable codes concurrently.

Signet Health offers a highly competitive salary and comprehensive benefits package.

Requirements/Qualifications

Qualifications:

• Holds a North Carolina licensure in nursing (RN) or allied health profession (PT, OT, SLP).
• Minimum of two years of experience in rehabilitation or a closely related field.
• Experience with CMS data collection, MDS, IRF-PAI, UDS.
• Experience with ICD 10 coding, preferred.