PPS Program Coordinator

We have the great privilege of helping patients and families re-build their lives. It’s extraordinarily meaningful work and the reason we greet the day with optimism and anticipation. When patients “Ask for Mary,” they experience a culture that has been sculpted for more than a century. Our hallmark is to carefully listen to patients and innovatively serve them. This is true of every employee, from support staff and leadership, to clinicians and care providers.

Mary Free Bed is a not-for-profit, nationally accredited rehabilitation hospital serving thousands of children and adults each year through inpatient, outpatient, sub-acute rehabilitation, orthotics and prosthetics and home and community programs. With the most comprehensive rehabilitation services in Michigan and an exclusive focus on rehabilitation, Mary Free Bed physicians, nurses and therapists help our patients achieve outstanding clinical outcomes. The growing Mary Free Bed Network provides patients throughout the state with access to our unique standard of care

Mission Statement

Restoring hope and freedom through rehabilitation.

Employment Value Proposition

At Mary Free Bed, we take pride in our values-based culture:

• Focus on Patient Care. A selfless drive to serve and heal connects all MFB employees.
• Clinical Variety and Challenge. An inter-disciplinary approach and a top team of professionals create ever-changing opportunities and activities.
• Family Culture. We offer the stability of a large organization while nurturing the family/team atmosphere of a small organization.
• Trust in Each Other. Each employee knows that co-workers can be trusted to make the right decision for our family, patients, staff, and community.
• A Proud Tradition. Years of dedicated, quality service to our patients and community have yielded a reputation that fills our employees with pride.

Summary

The PPS Program Coordinator responsible for assigned aspects of the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) Program at Mary Free Bed at Munson. The PPS Program Coordinator is responsible for training and ongoing collaboration with members of the treatment team that are involved in patient assessment and data reporting.

The PPS Program Coordinator responsible for assigned aspects of the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) Program at Mary Free Bed at Munson. The PPS Program Coordinator is responsible for training and ongoing collaboration with members of the treatment team that are involved in patient assessment and data reporting.

The PPS Program Coordinator works with physicians and coders to assure data is encoded and transmitted in accordance with Medicare guidelines and those requirements of other payors. The PPS Program Coordinator participates in staff education and quality assessment/improvement activities related to the IRF-PAI process.

The person in this role will also assist members of the leadership team to develop thorough documentation systems for all disciplines that reflect the complex nature of inpatient rehabilitation care, and that comply with Medicare guidelines.

Essential Job Responsibilities

Inpatient Rehabilitation Facility – Patient Assessment Instrument (IRF-PAI)

• Completes the IRF-PAI data which determine a patient’s RIC (Rehabilitation Impairment Category), CMG (Case Mix Group), and payment under the Rehabilitation Perspective Payment system.
• Develops and implements a schedule for completion of IRF-PAI according to Medicare requirements.
• Assures accuracy and thoroughness of data recorded.
• Coordinates the pre-admit assessment and screening process for patients in conjunction with the Admission Coordinators, Physicians and Coders.
• Comprehensively assesses the data gathered for the IRF-PAI and contributes to the development of the plan of care.
• Coordinates and completes the PAI on all other acute rehabilitation inpatients as part of the hospital outcomes tool.
• Works directly with the inpatient coding staff to properly identify and document all applicable codes on a concurrent basis.

Quality Reporting Program (QRP) - Educator

• Serves as the trainer and resource for the QRP scoring process for all direct care staff.
• Develops and implements QRP scoring competency testing for all direct care staff.
• Responsible for New Hire direct care staff QRP scoring education and competency.
• Through regular chart audits, determines areas for QRP focused education for accuracy.
• Communicates with the Supervisor of PPS Compliance when repeated QRP documentation concerns are identified.
• Maintains current knowledge of the QRP scoring process by attending National Education for current practice.
• Assures accuracy of QRP and other data entered.

Medicare Documentation Requirements

• As assigned by Inpatient Rehab Leadership, the PPS Program Coordinator serves as a clinical resource for PPS regulations and compliance, coding and billing related to the IRF-PAI, and CMS documentation requirements.
• In collaboration with Inpatient Rehab Leadership, provides physician and clinical staff education regarding regulatory requirements.
• Provides direct and timely feedback to physicians when required components of documentation are not present and provides suggestions for improvement.
• Assists with development of a comprehensive, integrated patient plan of care, as required by CMS.
• In collaboration with Inpatient Rehab Leadership, stays abreast of regulatory and accreditation changes that impact the rehabilitation industry.
• In collaboration with Inpatient Rehab Leadership, observes and analyzes systems through regular audits to enhance systems efficiencies and conducts quality assurance activities.

Physician Relations

• Maintains effective working relationships with the inpatient rehabilitation medical directors and other physicians that provide care to the patients served.

Staff Development and Mentoring

• Assists leadership in Inpatient Rehabs with leadership for the entire PPS program, including ongoing staff development and mentoring of other PPS team members. Encourages staff development through formal and informal learning opportunities.

Professional Work Environment

• Encourages a culture of personal accountability, solution-seeking behavior, and mutual respect, timely communication, openness to change, enthusiasm, and pride.

Interdepartmental and Interdisciplinary Collaboration

• Promotes collaboration within all disciplines within the inpatient rehabilitation unit, and with other departments and institutions.
• Works to effectively integrate all members of the patient care team to provide outstanding rehabilitation services

Billing/Reimbursement

• Works closely with billers and UM to ensure accuracy of claims information. Monitors post payment denials and appeals, working collaboratively to address issues.

We’ll embrace all people by:

• Treating everyone with dignity and respect.
• Opening more doors to opportunity for others to succeed.
• Growing talent and people.
• Ensuring a welcoming experience for all we serve, regardless of origin, race, religion, disability, sexual orientation or socioeconomic status.
• Taking action against discrimination.
• Honoring our differences and how we collaborate.
• Educating staff, patients and the communities we care for.
• Restoring hope and freedom, together.

Customer Service Responsibilities

Demonstrate excellent customer service and standards of behaviors as well as encourages, coaches, and monitors the same in team members. This individual should consistently promote teamwork and direct communication with co-workers and deal discretely and sensitively with confidential information.

Responsibilities in Quality Improvement

Contribute by identifying problems and seeking solutions. Promote patient/family satisfaction where possible; participates in departmental efforts to monitor and report customer service.

Essential Job Qualifications

• Education: Bachelor’s degree in clinical profession preferred – RN, PT, OT or ST.
• Experience:

• A minimum of two years of relevant clinical experience and direct experience with the Inpatient Rehabilitation Prospective Payment System (PPS) process.

• Skills and Attitude:

• Demonstrated excellent written and verbal communication skills.
• Information management skills to communicate, explain, interpret, and present data.
• Demonstrated ability to work both independently and in conjunction with a team of professionals for problem solving.
• Sense of urgency, collaborative team style, and ability to quickly adapt to changes in priorities.
• Ability to multi-task and delegate tasks for timely project completion.
• Demonstrated commitment to the organizational mission with a “whatever it takes” attitude to get the job done.

Physical Requirements for Essential Job Qualification

Levels:

• None (No specific requirements)
• Occasionally (Less than 1/3)
• Frequently (1/3 to 2/3)
• Majority (More than 2/3)

Remain in a stationary position: Frequently

Traverse or move around work location: Occasionally

Use keyboard: Frequently

Operate or use department specific equipment: None

Ascend/Descend equipment or ladder: None

Position self to accomplish the Essential Functions of the role: None

Receive and communicate information and ideas for understanding: Frequently

Transport, position, and/or exert force:

Up to 10 pounds: Occasionally

Up to 25 pounds: None

Up to 50 pounds: None

Up to 75 pounds: None

More than 100 pounds: None

Other weight: Up to___ pounds _____

Other: _____

Consistent with the Americans with Disabilities Act (ADA), it is the policy of Mary Free Bed Rehabilitation Hospital to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact the Talent Acquisition team at [email protected].

Mary Free Bed is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, age, genetic information, veteran status, disability or other legally protected characteristic.