PPS Coordinator

Prospective Payment System (PPS) Coordinator

Hitchcock Inpatient Rehab at Aiken Regional Medical Centers is consistently among the top performers in the CSRA, UHS facilities, and the country through strong functional outcomes, interdisciplinary communication and cooperation. 

The Prospective Payment System(PPS) Coordinator is responsible for overall coordination, completion and transmission of the Inpatient Rehab Facility Patient Assessment Instrument (IRF-PAI) with interdisciplinary team members accurately and within appropriate time frames. Responsible for education of staff regarding application of Care Tool completion and chart documentation for GG coding.  Assists with the collection of data and interpretation of performance improvement outcome information.

Job Duties:

• Demonstrates ability to prioritize multiple projects.
• Demonstrates effective time management skills.
• Demonstrates ability to create and use Excel including creation of tables, basic formulas, graphs etc.
• Demonstrates understanding and use of UDS data management system.
• Demonstrates competent use of the GG coding with Care Tool.
• Demonstrates understanding and use of pressure ulcer staging to apply to IRF-PAI documentation.
• Creates and maintains systems to ensure data collection for IRF-PAI, PI or other projects.
• Creates and maintains systems to calculate data collected for PI or other projects.
• Attends any hospital committee meetings as assigned by the Program Director.
• Acts as a resource person to the Rehabilitation unit and the hospital.
• Completes all mandatory hospital and rehabilitation department competencies as directed and within the assigned timeframes.
• Attends 80% of all required rehabilitation unit meetings and in-services.
• Collects and interprets data from Medical Records to complete IRF-PAI as required by Medicare.
• Collects and interprets data received from Coders to apply to IRF-PAI.
• Monitors and inputs appropriate information into the IRF-PAI.
• Reviews each IRF-PAI in total for accuracy before finalizing.
• Interacts appropriately with the Program Director when unable to resolve any data or timeliness issues related to the IRF-PAI. Transmits IRF-PAI to Medicare according to the hospital and Medicare policy.
• Coordinates IRF-PAI processes with various hospital departments to ensure timely billing and that there is appropriate retention of the IRF-PAI.
• Submits CMG's to the billing office to ensure accurate billing.                        
• Ensures the IRF-PAI is entered into the appropriate medical recording cooperation with medical records personnel.            
• Coordinates annual and ongoing education for therapy and nursing including required competency testing through UDS.
• Identifies discrepancies in Care Tool recording and works with staff on a real time basis to correct the errors prior to the discharge of the patient.
• Reports to the Program Director, any interdisciplinary team member who is not compliant with the rules and regulations associated with accurate and timely completion of the IRF-PAI.
• Assist Rehab Director and Medical Director by providing outcome reports as needed.
• Assist Rehab Director by identifying and monitoring trends in patient care as identified through the IRF-PAI process.            
• Assist Rehab Director with ongoing management of PI process and data collection.
• Assist Rehab Director in communication of outcome data to the team.
• Assists in insurance authorization process for patients in IRF.
• Tracking compliance and coordinates interdisciplinary weekly team conferences.
• Conducts self with professionalism and maintains ethical standards in communication with professional staff and strives to attain further knowledge and will educate others in their field on newly learned skills.

Job Requirements:

 Education requirements:                Associates Degree in nursing required; BSN preferred.                                           

Work experience requirements:                  2 years experience in a hospital/clinical setting with knowledge of clinical conditions. Experience in Rehab or skilled nursing setting preferred.                                        

Required licenses/ certifications/courses              Current RN license in South Carolina. Required to pass QI credentialing exam bi-annually.                                            

Required skills, knowledge and abilities:              Strong written and verbal communication skills required. Must be able to demonstrate the ability to work independently. Must possess critical thinking abilities and strong organizational skills.  Computer proficiency required, to include word processing, spreadsheet and database.       

Aiken Regional Medical Centers, located in Aiken, South Carolina, is a 273-bed acute care facility providing quality healthcare to the residents of Aiken and surrounding communities. Aiken Regional Medical Centers has been ranked a top hospital in South Carolina by the Carolina Center for Medical Excellence for its treatment of heart attack, heart failure and pneumonia. Services provided at the hospital include emergency medical care, orthopedic surgeries, maternity, and behavioral health services.

Benefit Highlights

• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries

Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

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