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General Summary

Plans, organizes and evaluates the Rehabilitation Prospective Payment System Process. Completes and submits timely and accurate Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) for each rehabilitation inpatient. Reviews medical record documentation to facilitate the accurate representation of the severity of illness, patient acuity and diagnoses for the specified patient population. Obtains appropriate clinical documentation through extensive interaction with physicians and other healthcare providers. Actively participates in meetings and education of physicians and staff related to clinical documentation management. Reviews all clinical documentation for accuracy, collaborating with staff and organizing and coding information into the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) and the designated hospital computer system. Must be knowledgeable in CMS guidelines relative to the assignment of Impairment Group Codes and sequencing of diagnoses, as well as standard ICD-10 Codes.

Duties and Responsibilities

Essential Functions:

+ Identifies admission and discharge assessment reference dates and appropriate impairment groups for the completion of the IRF-PAI for all patients. Understands the Case Mix Group (CMG) Classification System and ensures the appropriate documentation to support the treatment of the patient.

+ Works closely with the Coder III (Rehabilitation Specialty) to ensure accurate codes are entered onto the IRF-PAI

+ Coordinates the completion of admission and discharge assessments of the IRF-PAI within the timeframes specified by CMS. May require discussion/interaction (written or verbal) with various team members to reconcile differences in reported functional status to complete the IRF-PAI.

+ Ensures that the IRF-PAI reflects the functional status and 24-hour care needs of each patient to result in the correct Case Mix Group (CMG) assignments and proper billing.

+ Enters IRF-PAI data into the eRehab (or similar) computer software as required by CMS and attests to the accuracy and completeness of all the data submitted. Schedules and ensures electronic transmission of the IRF-PAI according to Prospective Payment System/Federal guidelines.

+ Educates the treatment team in utilization of eRehab software information to assist in the monitoring of the patient's progress within the program and program evaluation/outcomes measurement. Distributes this information to other identified members of the rehabilitation management team.

+ Monitors utilization and keeps clinical team and management apprised of variances in length-of-stay relative to the patient's CMG.

+ Works closely and collaboratively with all members of the clinical team to ensure compliance with state and federal regulations at all levels.

+ Serves as a resource/advisor to rehabilitation liaisons, other clinicians and physicians.

+ Provides outcomes reporting as requested.

+ Maintains updated information regarding facility compliance with federal regulations regarding what is commonly referred to as the "60% Rule," and disseminates this information regularly to appropriate management staff, including the hospital compliance officer.

+ Maintains a current knowledge of the eRehab software and serves as subject-matter expert within the inpatient rehabilitation setting.

+ Facilitates modifications to clinical documentation to ensure that appropriate reimbursement is received for the level of service rendered to all patients by completing accurate and timely record reviews.

+ Improves the overall quality and completeness of clinical documentation by performing admission and continued stay reviews.

+ Educates all internal customers on compliant documentation opportunities, reimbursement issues, as well as performance improvement methodologies.

+ Prepares educational materials for presentation at meetings, physician grand rounds, interdisciplinary rounds, physician staff meetings, and participates in new provider orientations.

Common Expectations:

+ Accepts and utilizes administrative direction and consultation.

+ Maintains confidentiality of patient and organizational information

+ Elicits feedback from appropriate sources regarding the quality of services provided.

+ Enhances professional growth and development through advanced/continuing education to maintain up-to-date knowledge, skills, and competencies.

+ Maintains established policies and procedures, objectives, quality assessment, safety, environmental, and infection control standards.

+ Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

+ Assists in the identification and generation of management reports.

Qualifications

Minimum Education:

+ Masters Degree In PT, OT or SLP. Required or

+ Bachelors Degree RN. Required

Work Experience:

+ 3 years In inpatient rehabilitation. Required

Licenses:

+ Licensed Physical Therapist Upon Hire Required or

+ Licensed Occupational Therapist Upon Hire Required or

+ Licensed Speech-Language Pathologist Upon Hire Required or

+ Licensed Registered Nurse Upon Hire Required or

+ Registered Nurse Multi State License Upon Hire Required

Courses and Training:

+ Graduate of an accredited Allied Health program. Upon Hire Required and

+ Training on eRehab software. Upon Hire Preferred

Knowledge, Skills, and Abilities:

+ Ability to handle multiple priorities.

+ Exercises sound judgment and works effectively under pressure.

+ Strong attention to detail, interpersonal skills, organizational skills and written and oral communication skills.

+ Demonstrated ability to coordinate efforts within a multi-disciplinary team.

+ Intermediate computer skills in Microsoft Word and Excel.

+ Proficient in Quality Indicator scoring.

+ Proficient in coding for rehabilitation.

Quality of Life

Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation.

Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more - within an easy drive of major East Coast cities.

York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)

WellSpan Health is an Equal Opportunity Employer. It is the policy and intention of the System to maintain consistent and equal treatment toward applicants and employees of all job classifications without regard to age, sex, race, color, religion, sexual orientation, gender identity, transgender status, national origin, ancestry, veteran status, disability, or any other legally protected characteristic.