Coordinator Prospective Payment System - Inpatient Rehabilitation
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McLaren Health Care
Pontiac, MI, US
Summary
Facilitate and coordinate the Prospective Payment System for the Inpatient Rehabilitation Unit while ensuring compliance with federal Medicare regulations. Manage data analytics, quality monitoring, and the accurate submission of IRF-PAI documentation to ensure proper payment.
Job Description
Department: Inpatient Rehabilitation
Daily Work Times: Variable
Shift: Days
Scheduled Bi-Weekly Hours: 64
Position Summary: Responsible for facilitating and coordinating the Prospective Payment System (PPS) for the Inpatient Rehabilitation Unit.
This position is a part-time (32 hours per week) position. There may be some remote work opportunity within one year.
Essential Functions and Responsibilities:
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Predicates the RIC in coordination with coding and the interdisciplinary team and assists the screening process for potential candidates to the Rehabilitation Unit; ensures that patients meet the criteria for admission to the rehabilitation unit.
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Attends the team conferences to comprehensively assess the data gathered for the IRF-PAI and assists in the development of the Individualized Plan of Care.
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The position requires learning and staying abreast of Medicare regulations for the Inpatient Rehabilitation Facility or Unit.
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Responsible for the federal requirement of the 60%25 compliance rule reporting and tracking. Prepares the annual report with the required data for each admission and discharge to be submitted to the state for attestation of compliance to the 60%25 rule.
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Establishes and maintains excellent guest relations and customer service.
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Expert on the Federal Register requirements for payment through the IRF-PAI submission requirements.
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Responsible for the education including functional assessments to staff, physicians, coding, finance and the rehabilitation leadership team regarding the required elements of the PPS system.
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Participates in performance improvement activities and assists in the development of quality monitors and collection of data.
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Runs reports from the rehabilitation software to assist leadership and the rehab team with data analytics.
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Responsible for completion and submission of the IRF-PAI to ensure accurate payment and to avoid payment penalties.
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May obtain pre and re-authorization from payers as needed.
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Performs other related duties as required and directed.
Qualifications:
Required:
· State licensure/certification in the field of nursing, physical therapy, occupational therapy, or speech language pathology.
· Associate degree in discipline.
· Two years in related health care field.
Preferred:
· Bachelor’s degree
· Licensure/certification in rehab discipline.
McLaren Health Care, headquartered in Grand Blanc, Michigan, is a $7.3 billion, fully integrated health care delivery system committed to quality, evidence-based patient care and cost efficiency. The McLaren system includes 12 hospitals in Michigan, ambulatory surgery centers, imaging centers, a 640-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering more than 732,838 lives in Michigan and Indiana, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, a National Cancer Institute-designated comprehensive cancer centers. McLaren has 20,000 full-, part-time and contracted employees and more than 113,000 network providers throughout Michigan, Indiana and Ohio.
As part of its Graduate Medical Education (GME) program, McLaren maintains academic affiliations with medical schools at Wayne State University, Michigan State University and Central Medical University. McLaren’s seven (7) GME campuses offer 27 residencies and eight (8) fellowship programs that train over 650 future physicians annually. All GME programs at McLaren are overseen and managed centrally by the Department of Academic Affairs.
As part of its Graduate Medical Education (GME) program, McLaren maintains academic affiliations with medical schools at Wayne State University, Michigan State University and Central Medical University. McLaren’s seven (7) GME campuses offer 27 residencies and eight (8) fellowship programs that train over 650 future physicians annually. All GME programs at McLaren are overseen and managed centrally by the Department of Academic Affairs.
Founded
1914
Company size
10,001+ employees
Industry
Hospitals and Health Care
Org type
Nonprofit
Headquarters
Grand Blanc, MI
McLaren Health Care, headquartered in Grand Blanc, Michigan, is a $7.3 billion, fully integrated health care delivery system committed to quality, evidence-based patient care and cost efficiency. The McLaren system includes 12 hospitals in Michigan, ambulatory surgery centers, imaging centers, a 640-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering more than 732,838 lives in Michigan and Indiana, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, a National Cancer Institute-designated comprehensive cancer centers. McLaren has 20,000 full-, part-time and contracted employees and more than 113,000 network providers throughout Michigan, Indiana and Ohio.
As part of its Graduate Medical Education (GME) program, McLaren maintains academic affiliations with medical schools at Wayne State University, Michigan State University and Central Medical University. McLaren’s seven (7) GME campuses offer 27 residencies and eight (8) fellowship programs that train over 650 future physicians annually. All GME programs at McLaren are overseen and managed centrally by the Department of Academic Affairs.
As part of its Graduate Medical Education (GME) program, McLaren maintains academic affiliations with medical schools at Wayne State University, Michigan State University and Central Medical University. McLaren’s seven (7) GME campuses offer 27 residencies and eight (8) fellowship programs that train over 650 future physicians annually. All GME programs at McLaren are overseen and managed centrally by the Department of Academic Affairs.
Founded
1914
Company size
10,001+ employees
Industry
Hospitals and Health Care
Org type
Nonprofit
Headquarters
Grand Blanc, MI