Rehab Coordinator

IRF-PAI Management:

Complete, encode, and submit IRF-PAI assessments and CMS Quality Indicators (e.g., Section GG) within required timeframes.

Collect, enter, analyze, and transmit clinical data in compliance with Medicare PPS requirements.

Ensure accuracy and completeness of all data submitted for CMS reimbursement.

Maintain current knowledge of IRF-PAI data definitions, coding rules, and submission guidelines. Quality and Safety Measurement - Support abstraction, analysis, and reporting of clinical quality measures for internal and external programs. - Monitor performance metrics and identify trends in quality and patient outcomes. - Conduct data audits to ensure accuracy, completeness, and regulatory compliance. - Assist with quality improvement initiatives and reporting requirements. Chart & Coding Review:  Perform concurrent medical record reviews to assign appropriate Impairment Group Codes (IGC), etiologic diagnoses, and comorbidities.  Collaborate with coding and revenue cycle teams to ensure accurate reimbursement.  Monitor documentation to support coding accuracy and regulatory compliance. Interdisciplinary Collaboration: - Partners with physicians, therapists, nursing, and case management to ensure documentation reflects patient severity and care needs. - Participate in interdisciplinary rounds and team conferences to support care planning and length-of-stay (LOS) management. - Assist with patient screening for rehabilitation appropriateness. - Provide backup support for admissions coordination as needed. Audit & Compliance: - Monitor key IRF metrics (e.g., LOS, Case Mix Index, ADC, CMGs). - Ensure compliance with CMS requirements, including the 60% rule, 3-hour rule, and documentation standards. - Prepare for audits, medical reviews, and Additional Documentation Requests (ADRs). - Support Utilization Review processes and regulatory survey readiness. - Track regulatory updates and ensure adherence to current standards. Education & Training: - Educate clinical staff on CMS documentation requirements, IRF-PAI scoring, and PPS guidelines. - Provide ongoing training on quality measures and rehabilitation program metrics. - Support staff competency in regulatory and documentation standards. - Maintain required continuing education and professional development. Additional Duties - Perform other duties as assigned to support departmental and organizational goals. QUALIFICATIONS/REQUIREMENTS: Clinical License/Training: - Requires an active state license as a Registered Nurse (RN), Physical Therapist (PT), Occupational Therapist (OT), Speech-Language Pathologist (SLP), or Medical Social Worker (LMSW). - UDS training & certifications in PPS required within 1 year of hire Experience : - Minimum of 5 years of clinical experience in an inpatient rehabilitation setting. - Deep understanding of CMS IRF guidelines, Medicare billing, and proficiency with specialized software (e.g., UDS-Pro/UDSmr). Skills : - Strong analytical abilities, attention to detail, and excellent communication skills. - Demonstrates professional work behavior - Complies with departmental organizational policies and procedures and adheres to external agency/ regulatory requirements. - Proficient in word, excel, MS Teams, outlook - Understanding of EPIC EMR preferred.