Prospective Payment System Coordinator RN or PT

1 week ago

Aurora, Colorado, United States HCA HealthONE Spalding Rehabilitation Full time
Job Summary

We are seeking a highly skilled and detail-oriented Prospective Payment System Coordinator to join our team at HCA HealthONE Spalding Rehabilitation. As a key member of our inpatient rehabilitation team, you will be responsible for coordinating patient information for Medicare reimbursement and maximizing Length of Stay (LOS) efficiency.

Key Responsibilities
  • Oversee and ensure the accuracy and completion of the Inpatient Rehabilitation Facility – Patient Assessment Instrument (IRF-PAI) prior to electronic transmission within required time frames.
  • Maintain a current knowledge of IRF-PAI software and provide expertise on this software within the inpatient rehab setting.
  • Maintain updated and ongoing knowledge of the regulations concerning the IRF-PAI and its completion within the inpatient rehab setting.
  • Thoroughly research and review clinical documentation and make recommendations to clinical supervisors in areas needing improvement to support and validate rehab criteria and documentation compliance.
  • Collaborate with physicians and interdisciplinary team members to capture accurate assessment of patient, including interdisciplinary patient treatment plans to facilitate achievement of expected outcomes in collaboration with interdisciplinary team.
  • Verify appropriate CMG (case mix group) designation through chart review, staff interview, and collaboration with the rehab medical director.
  • Participate in ongoing education to the staff to ensure accurate and timely completion of the IRF-PAI.
  • Periodically audit IRF-PAI, clinical documentation and billing information to ensure accuracy and consistency of documentation.
  • Evaluate patterns of variances from standardized care plans and recommend strategies to resolve individual and caseload issues.
  • Serve as a resource to department staff, students, volunteers and other departments, and contribute to the teamwork essential to ensuring quality patient care.
  • Promote participation, cooperation and teamwork. Demonstrate problem solving in resolving issues.
  • Participate in hospital or departmental performance improvement activities and seek opportunities to improve department and inter-department processes.
  • Participate in internal chart review and external audit coordination as needed.
Requirements
  • Currently licensed in CO as a Registered Nurse or Therapist (all therapy disciplines accepted - PT, OT, SLP).
  • Bachelor's degree from an accredited school in Nursing or Physical Therapy.
  • Prefer at least 2 years previous experience as a licensed clinician in an Inpatient Rehabilitation and a working knowledge of IRF-PAI & CARE Tool.
About Us

HCA HealthONE Spalding Rehabilitation is a 42-bed licensed rehabilitation hospital that has been rebuilding lives and renewing hope since 1968. We offer intensive inpatient and outpatient rehabilitation programs tailored specifically to patients' needs. As a member of our team, you will be part of an organization that invests in you and values diversity.

We are an equal opportunity employer and do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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