This position educates staff and physicians to ensure documentation requirements are met. This position has broad interaction with clinical staff, HIM and the medical staff and has frequent interaction with the Medical Director as it relates to medical staff documentation compliance and physician management of PPS dates.
The PPS Coordinator reviews and analyzes IRF-PAI and other health records to identify relevant healthcare information for distinct patient rehabilitation encounter. The PPS coordinator is responsible for translating Rehabilitation Impairment Groups, Etiologic Diagnosis, Comorbid Conditions and Complication phrases utilized by healthcare providers into a coded form. The translation process required interaction with healthcare provider to ensure that terms had been translated correctly. The coded information that is a product of the coding process is then utilized for reimbursement purposes, in the assessment of rehabilitation clinical care, to support medical research activity and to support the identification rehabilitation healthcare concerns critical to the public at large.
The PPS coordinator must have a thorough understanding of the content of the IRF-PAI and medical records in order to be able to locate information to support or provide specificity of tier assignment for CMG and average length of stay (ALOS)
This position is challenged to be aware of the continual changes in the Federal and State regulations for prospective payment. Keep informed of changes in treatment plans and complications and perform coding recommendations when physician documentation is vague or missing.
Knowledge, Skills & Abilities
- Excellent written and verbal communication skills.
- Knowledge of Functional Independent Measures (FIM's) and the correlation to patient length of stay (LOS)
- Ability to translate medical data for effective education and communication.
- Knowledge of research basics and the ability to format medical information into a criteria document.
- Ability to assess a situation, consider alternative and take appropriate actions.
- Ability to manage change
- Excellent organizational and time management skills.
This position does not provide patient care.
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