Community Health Systems PPS Coordinator Admission Liaison in Sharon, Pennsylvania
PPS Coordinator duties include, entering all CMS required information on each patient in the UDS system then formulate and transmit the IRF- PAI bill to CMS for process of payment.
Responsible to identify and resolve any outstanding cases as identified from billing department on BARRT report, perform internal audits as outlined by program director, following audit tool, on regular basis to identify and correct any missing or required information, work with coders to track and ensure that admission and discharge coding is captured and entered in timely manner and that coding is accurate and relevant to case.
Screen all identified in-house patients and coordinate/review with physician for admission to IRF.
Works closely with CM/SW on acute care with attendance of their team huddle to assist in identification of potential patient s that will benefit from IRF admission.
Review all eligible patients to verify meeting qualifying criteria as outlined by CMS, complete pre admission screen for all eligible patients in timely manner and present to physician for review and signature, review external liaison s cases for qualifications to IRF and review all pre admission screens.
Directs all discharge planning at formal Interdisciplinary team meeting weekly, as required for each patient, perform “mini team meeting each week to capture all patients needed in 7 day timeframe as required by CMS, performs all case management duties of obtaining initial authorizations from insurance companies for each eligible patient from within hospital and as needed for all external admissions with concurrent authorizations as required.
Assists with coordinating all yearly mandatory FIM education and certification for staff, assist in completion with external liaison of weekly tracking/dashboard report of patient referrals.
Works with patients, families and staff on identified patient s with complicated discharge for discharge planning resolution.
Cover all external referrals when needed for external liaison.
Responsible to perform all duties independently under direction of Program Director and within guideline and regulations of Inpatient Rehab facility as set forth by Sharon Regional Health System/Stewart Group and CMS.
Requires an associate's degree and is certified as a registered nurse. Familiar with standard concepts, practices, and procedures within a particular field.
The following background screenings are a requirement if hired for the position:
Pennsylvania Act 33/34/73/15 and Ohio FBI (if an Ohio Resident).
Facility will provide instruction on the background screenings if contacted for the position.
Job: Rehabilitation, Inpatient
Organization: Sharon Regional Hospital
Requisition ID: 1754600