Northwestern Memorial HealthCare

Prospective Payment System Coordinator - Rehabilitation Coordinator

Hospitals & Medical Centers
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree in Physical Therapy, Occupational Therapy, Therapeutic Recreation, Nursing, or a related field.
  • Current Michigan license/certification.
  • Minimum of 3 years relevant clinical experience in inpatient rehabilitation.
  • Experience in a Prospective Payment System (PPS) role is preferred.
  • Exceptional organizational, communication, and interpersonal skills.
  • Strong problem solving and critical thinking abilities.
  • Ability to work effectively in multidisciplinary teams.

Responsibilities

  • Coordinate accurate completion of the Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI).
  • Review patient admission baselines and discharge documentation.
  • Ensure quality indicator measures for functional abilities are accurately documented.
  • Collaborate with clinical team members to resolve documentation discrepancies.
  • Verify Case Mix Group (CMG) designations through chart reviews.
  • Transmit IRF-PAIs to Medicare and manage associated billing entries.
  • Track and evaluate Quality Indicator audit changes and identify improvement trends.

Benefits

  • Comprehensive benefits program competitive with industry standards.
  • Opportunities for training and educational development.
  • Supportive work environment that values excellence and teamwork.
Full Job Description
Job Description Summary
The Prospective Payment System Coordinator (PPS Coordinator) is responsible for clinical data collection, data entry, transmission and analysis of Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) data, while ensuring compliance with Medicare Prospective Payment System (PPS). The role is responsible for facilitating communication between the PPS processing team and practice areas to identify appropriate documentation for patients. The PPS Coordinator serves as a leader through consultation, collaboration and validation of the interdisciplinary PPS documentation.

The PPS Coordinator will consistently demonstrate support of the Shirley Ryan AbilityLab statement of Vision, Mission and Core Values by striving for excellence, contributing to the team efforts and showing respect and compassion for patients and their families, fellow employees, and all others with whom there is contact at or in the interest of the institute.

The PPS Coordinator will demonstrate Shirley Ryan AbilityLab Core Attributes: Communication, Accountability, Flexibility/Adaptability, Judgment/Problem Solving, Customer Service and Core Values (Hope, Compassion, Discovery, Collaboration, and Commitment to Excellence) while fulfilling job duties.

Job Description

The PPS Coordinator will:
  • Coordinate the data collection and accurate completion of the IRF-PAI.
  • Review and determine appropriate admission baseline and discharge.
  • Quality Indicator (QI) measures for functional abilities based on documentation supported in the patient record.
  • Collaborate with clinical team members for any missing and/or errant entries to resolve documentation discrepancies.
  • Verify appropriate Case Mix Group (CMG) designation through chart review and collaboration with coding and medical staff.
  • Transmit IRF-PAIs to Medicare and post assigned HIPPS codes in SRALab billing application.
  • Track and evaluate QI audit changes and identify trends needing improvement.
  • Prepare and discuss findings of SRAlab outcome trends and National Benchmarks with Supervisor, PPS Processes and Innovation Teams/Leaders.
  • Provide training and mentoring to staff on the PPS process, including Quality Indicator (QI) training Educate and coach staff on scoring discrepancies, measure definitions and outcome opportunities.
  • Assist with competency and educational development with SRAlab Academies related to the IRF-PAI.
  • Collaborate with Quality teams for accurate data collection of publicly reported IRF-PAI items.
  • Perform all other duties assigned in the best interest of the Shirley Ryan AbilityLab.


Reporting Relationships:
  • Reports directly to the Administrative Director Henry Ford Health


Knowledge, Skills & Abilities Required
  • A professional level of knowledge obtained by a Bachelor's Degree or higher in a specialized field: Physical Therapy, Occupational Therapy, Therapeutic Recreation, Nursing or related field.
  • Current Michigan license/certification.
  • Minimum 3 years of relevant clinical experience in an inpatient rehabilitation setting.
  • Prior experience in a PPS role preferred Exceptional organization, communication and interpersonal skills.
  • Excellent problem solving and critical thinking abilities.
  • Ability to take ownership of serving the customer, team, and organization, of achieving goals and of resolving problems.
  • Ability to work with multidisciplinary teams throughout the organization.
  • Ability to adapt to changing work demands and work environment.
  • Proficiency in working with electronic medical record, Cerner preferred, eRehabData and CMS iQIES system programs.
  • Current basic working knowledge of Excel, Power Point, and Word applications.


Working Conditions
  • Normal office environment with little or no exposure to dust or extreme temperature. Includes Saturday, Sunday and Holiday rotation work.


The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.

Pay and Benefits*:

Pay Range:
$71,200.00 - $124,500.00

Benefits:

Shirley Ryan AbilityLab offers a comprehensive benefits program that is competitive with our industry peers in our geographic locations: https://www.sralab.org/benefits

*Benefits and benefits' eligibility can vary by position. Actual compensation will be determined by equity and qualifications of the role.

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