"Alerted.org

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Job Location (Full Address):

601 Elmwood Ave, Rochester, New York, United States of America, 14642

Opening:

Worker Subtype:

Regular

Time Type:

Full time

Scheduled Weekly Hours:

40

Department:

500306 PM&R Inpatient Admin

Work Shift:

UR - Day (United States of America)

Range:

UR URG 105 H

Compensation Range:

$19.96 - $27.94

_The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._

Responsibilities:

GENERAL PURPOSE:

Serves as the lead contact at the department level for two or more of the following functions: billing, payment posting, charge entry, accounting, coding compliance, and/or patient inquiries. Responsible for assigning and reviewing daily operations for these functions. Trains new employees and monitors quality and quantity of work performed in the department. Performs quality assurance monitoring for all activities in the area of responsibility.

ESSENTIAL FUNCTIONS

+ Provide administrative coordination of inpatient rehabilitation Prospective Payment System requirements:

+ Facilitate the accurate collection of clinical data necessary to complete the IRF-PAI

+ Coordinate efforts of Patient Accounts, Medical Records, and Clinical Staff for the optimal submission of CMS required information, including ICD-10 codes (25%)

+ Responsible for submission of all required IRF-PAI elements to CMS (5%)

+ Provide monthly case mix data and predict payments per UDSmr software capability.

+ Ability to provide accurate reports using UDSmr data and develop and implement staff training models for the completion of the IRF-PAI

+ Maintain and access data to analyze clinical utilization and costs (10%)

+ Measure and maintain clinical staff competency in Quality Indicator (FOM Functional Outcome Measures) scoring

+ Collaborate with faculty and clinical managers to identify opportunities for optimizing cost containment

+ Assist in the ongoing monitoring of identified benchmarks for the inpatient population.

+ Works closely and collaboratively with all members of the inpatient team to assure compliance at all levels (10%)

+ Efficiently enters all new admissions and identify target Case Mix Group (CMG) LOS, which is communicated to the attending physicians. (5%)

+ Enter timely CMG information in eRecord workqueue so billing can be sent out within 10 days of discharge. (5%)

+ Ongoing Quality Indicators (FOM) rounding, auditing, education and training with clinical staff (10 %)

+ Coordinates all referrals and admissions, contacts third-party payers to verify insurance eligibility and obtain precertification for inpatient rehabilitation AND Initiates appeal process for any denials (20%)

+ Design and maintain robust data system to capture and analyze information regarding patients served by the PM&R Consult team and provide reports and analysis of data based on team’s needs (5%)

+ Determines and submits the necessary supporting documentation required to complete the precertification process AND Communicates with Utilization Management and Financial Counseling throughout the admission to ensure payment for rehab services (5%)

QUALIFICATIONS

+ Associate’s degree in business field required

+ Minimum of two years’ experience in rehabilitation or a closely related field strongly preferred

+ Experience with ICD 10 and IRF-PPS preferred

+ 4-5 years of experience in hospital billing, accounting, and/or coding; or an equivalent combination of education and experience required

+ Strong verbal and written communication skills. Ability to work independently and prioritize time-sensitive tasks required

+ ‘PPS bootcamp’ training will be required of successful candidate required

The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Classes). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates for all persons consistent with our values and based on applicable law.

Notice: If you are a **Current** **Employee,** please **log into myURHR** to search for and apply to jobs using the Jobs Hub. Your application, if submitted using this portal, cannot be moved forward.

Learn. Discover. Heal. Create.

Located in western New York, Rochester is our namesake and our home. One of the world’s leading research universities, Rochester has a long tradition of breaking boundaries—always pushing and questioning, learning and unlearning. We transform ideas into enterprises that create value and make the world ever better.

If you’re looking for a career in higher education or health care, the University of Rochester may offer the perfect opportunity for your background and goals

At the University of Rochester, we are committed to fostering, cultivating, and preserving an inclusive and welcoming culture and are united by a strong commitment to be ever better—Meliora. It is an ideal that informs our shared mission to ensure all members of our community feel safe, respected, included, and valued.