Prospective Payment System (PPS) Coordinator (RN, PT, OT, SLP)

Signet Health; Fresno (CA); On-site; USD 90,000 - 120,000; Full time

Job summary

Signet Health is seeking a Prospective Payment System (PPS) Coordinator for the rehabilitation program at Community Regional Medical Center in Fresno, CA.

The role focuses on data collection for IRF-PAI, CMS compliance, coding accuracy, and collaboration with HIM and clinical teams to optimize reimbursement and reporting.

Qualifications

• Current California state licensure in nursing or allied health profession.
• Minimum of two years experience in rehabilitation or related field.
• Experience with ICD-10 coding preferred.
• CMS data collection, MDS, IRF-PAI, OASIS experience desirable.

Responsibilities

• Coordinates data collection on IRF-PAI for CMS submission.
• Ensures documentation supports coding and reimbursement.
• Educates clinical staff to maintain CMS compliance.
• Guides team on GG scoring and rating processes.
• Reviews IRF-PAI data and assists leadership with actions.
• Advises rehab physicians on tier codes for reimbursement.
• Performs audits to improve scoring and quality measures.
• Schedules timely IRF-PAI completion for each patient.
• Reports key metrics at daily leadership meetings.
• Collaborates with HIM coding to document applicable codes.

Skills

Rehabilitation data collection

CMS guideline compliance

IRF-PAI understanding

Stakeholder education

Education

California RN license

Allied health license (PT/OT/SLP)

Tools

ICD-10 coding

CMS data systems

IRF-PAI tools

Job description

Overview

Prospective Payment System (PPS) Coordinator

Acute Inpatient Rehabilitation

Community Regional Medical Center

Fresno, CA

Signet Health, a national acute rehabilitation and behavioral health company is seeking a Prospective Payment System (PPS) Coordinator for the rehabilitation program at Community Regional Medical Center in Fresno, CA.

The PPS Coordinator plays a vital role in the management and optimization of reimbursement for inpatient rehabilitation services.

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

Responsibilities include, but are not limited to:

• 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.
• Collaborates closely with HIM coding department to identify and document all applicable codes concurrently.

Requirements/Qualifications

Qualifications:

• Current California state licensure in nursing (RN) or allied health profession (PT, OT, SLP) required.
• Minimum of two years experience in rehabilitation or a closely related field required.
• Experience with ICD 10 coding preferred.
• Previous experience with CMS data collection, MDS, IRF-PAI, OASIS.