Oversees the coordination of all clinical documentation required for completion of the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI), and provides oversight regarding the length of stay in collaboration with the clinical team. Conducts ongoing review of the CMS data submitted and the patient's medical record to assure that the documentation is accurate and that the data is congruent.
Must Have: Physical Therapy, Registered Nurse or Occupational Therapy license
Job Duties:
Reviews and verifies the accuracy of all documentation for submission to the Centers for Medicare and Medicaid Services (CMS), confers with the clinical team, and directs the correction of documentation on the IRF-PAI when indicated
Reviews all co-morbidities on the IRF-PAI and in the Medical Record to assure that co-morbidities are properly captured and documented in both locations according to coding conventions.
Provides feedback and analyzation to the hospital CEO regarding the patients currently in house and their status with regard to the targeted length of stay. Including outcome information regarding patient's compliance, medical necessity, and clinical documentation effecting facility's outcomes.
Provides the team members with correct information regarding the targeted length of stay and works closely with the Case Management department regarding utilization review both concurrently and retrospectively, and participates in any site-specific utilization review activities.
Manages PPS coordinators at the facility site
Works directly with any clinical department to focus on documentation trends and corrective action to assure that the Medical Record documentation supports the IRF-PAI documentation
Reviews Rehabilitation Impairment Categories and admission ICD-10 codes to assure congruence and proper coding for the IRF-PAI. Makes any necessary changes in collaboration with the clinical team and physician.