Prospective Payment System (PPS) Coordinator

Acute Inpatient Rehabilitation

Community Regional Medical Center

Fresno, CA

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

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.

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.