Inpatient Rehabilitation is a post-acute level of care which operates under the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS).  The PPS Coordinator oversees all aspects of data collection for, and timely transmission of the Inpatient Rehab Facility Patient Assessment Instrument (IRF-PAI) in accordance with Centers for Medicare and Medicaid Services.  This individual utilizes specialty knowledge of IRF Medicare rules and regulations to support compliant billing for all cases discharged from the 40 bed, U-M Health joint venture inpatient rehabilitation unit at Chelsea Hospital.  The PPS Coordinator collaborates with Medical Coding to ensure congruency with rehab coding guidelines and to align the IRF-PAI with the UB-04 claim for proper payment.  This position plays a key role in quality and process improvement initiatives directly impacting reimbursement and documentation quality.

    IRF-PAI Data Management

• Completes Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) for each patient admitted and discharged.  Requires coding in accordance with the CMS IRF-PAI Coding manual as well as facility specific guidelines. Ensures data transcription accuracy and presence of supporting documentation in the medical record from physician and clinical staff.
• Responsible for accuracy of IRF-PAI ICD-10-CM coding: assigns all Rehabilitation Impairment Group Categories (IGCs), reviews and modifies etiologic diagnoses and comorbid conditions as needed
• Performs timely documentation queries with the physician, clinical staff and HIM necessary to maximize reimbursement, ensure IRF QRP (Quality Reporting Program) compliance and accuracy, as well as 60% compliance.
• Adheres to internal workflow timing guidelines as it relates to admission and discharge coding.  Submits IRF-PAI to CMS in accordance with both internal timing guidelines and CMS expectations.
• Provides CMG length of stay (LOS) guidelines for team meetings based on clinical data to support appropriate bed utilization and minimize audit risk for LOS outliers.
• Maintains updated and ongoing knowledge of federal regulations concerning the IRF PPS and IRF-PAI to ensure compliance and proper billing.  This includes participating in the operationalization of annual IRF-PAI updates and CMS Quarterly clarifications.
• Maintains IRF-PAI Workflow process document through quarterly review and updates 

    Quality and Process Improvement

• Continuously evaluates IRF clinical documentation quality improvement opportunities in collaboration with PPS group and rehabilitation leadership team related to reimbursement optimization, the quality reporting program, and patient outcome accuracy.
• Actively participates in the development, modification, and implementation of policies and procedures related to IRF-PAI coding.
• Collaborates to develop, test, and enhance EMR solutions for compliance with IRF-PAI coding requirements with focus on PPS workflow efficiency
• Assists with implementation of process-improvement and risk mitigation projects and initiatives to ensure compliance with current CMS regulations.

    Faculty/Staff Education

• Provides ongoing feedback and education to physicians, nurses, therapists, and HIM coders.  Communicates the principles and importance of accurate and complete documentation.  Prepares case-specific documentation examples to be given tot eh clinical treatment teams and departments.
• Participates as needed in the delivery of IRF PPS education on Section GG, Medicare guidelines, and documentation requirements to Clinical Team and reports on adherence and issues to rehab management team

    General

• Participate in department/unit activities including, but not limited to, staff meetings and in-services.
• Performs other duties as assigned in order to maintain the efficiency of the department

• Minimum of a bachelor's degree in a recognized field which is directly related to the duties of the position
• Minimum of 2-3 years of experience or knowledge in the delivery of patient care needed to perform the duties of the position
• At least 3 years of experience in analyzing and interpreting process, clinical outcomes and costs of care
• Experience working within an electronic medical record including efficient review of clinical documentation
• Detail-oriented with strong organizational, analytical, and problem-solving skills 
• Proficiency in database and spreadsheet creation and analysis, (Excel) and presentation software
• Ability to navigate the electronic health record (Epic preferred) to identify documents for review to provide accurate capture of clinical information
• Must be detail oriented with strong analytic and problem-solving skills, exceptional communication skills (both verbal and written) as well as exceptional presentation skills

• Clinical background or experience in inpatient rehabilitation administration, coding, billing, or utilization review preferred
• Medical chart auditing experience preferred

This is a hybrid position but may consider fully remote. Flexible hours available between 6AM-5PM Monday-Friday.

This position reports to the IPR Administrative Operations Manager.

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings.  Background screenings are performed in compliance with the Fair Credit Report Act.

Job openings are posted for a minimum of seven calendar days. This job may be removed from posting boards and filled anytime after the minimum posting period has ended.

The University of Michigan is an equal employment opportunity employer.