Posted: 08/26/2015 | Employer: St. Luke's Hospital
PPS Coordinator-Acute RehabDepartment: 01 8W REHAB P CARESchedule: Part-timeShift: As scheduledHours: .80, M-F, e/2nd or 3rd w/end, as scheduled, Req # - 14248Contact Information:
Contact: Human Resources
Tel: 218-249-5387/888-891-8950
Fax: 218-249-6094
Email: HumanResources@slhduluth.com
Address:
915 E. 1st Street, Duluth, MN 55805 Duluth, MN 55805
Job Details:
Graduate of an accredited school of nursing
MN RN licensure prior to start
Three (3) years relevant experience is required
JOB SUMMARY The PPS Coordinator-Acute Rehab is a finance related position requiring clinical skills to develop, implement and manage a successful CMS program from admission to discharge to any related post discharge reimbursement audit. Responsible for ensuring implementation and monitoring of compliant documentation strategies and utilization management principles. Is responsible for seeking to obtain maximal appropriate reimbursement for the 19 bed acute rehab unit by utilizing DRG coding summary in accordance with official AHA coding guidelines to complete the required PPS documentation for Medicare. Serves as the primary compliance and reimbursement specialist liaison with Patient Accounting, Health Information Management and Regulatory/Compliance Services. Collaborates with acute rehab physicians, nurses, therapy staff, social worker and other healthcare team members to assist as needed to coordinate health care services that optimize clinical outcomes and patient satisfaction with services from preadmission through post discharge transition. Also serves as backup for acute rehab social worker and case coordinator functions. MINIMUM QUALIFICATIONS Education: Graduate of an accredited school of nursing.Experience: Minimum of three (3) years of acute care and/or long term care work experience.Licensure/Certification/Registration: Current Minnesota RN license. PREFERRED QUALIFICATIONS Education: Baccalaureate degree.Experience: Previous experience with Functional Independence Measures (FIM) scoring and CMG coding. Experience using Uniform Data System. Previous work experience with utilization review and coding. Previous experience with Medicare or CMS, PPS System, inpatient rehab unit admission and exclusion criteria.Experience with Microsoft Office applications including MS Word and Excel. Experience with UDS.Licensure/Certification/Registration: CRRN licensure upon hire. KNOWLEDGE, SKILLS AND ABILITIES Ability to effectively communicate with medical staff, health care personnel and third party payors. Ability to effectively communicate and work closely with other case managers and all members of the health care team in such fashion as to make the program a continuing functioning process. Understands that St. Luke's is committed to following ethical procedures and remaining within the boundaries of the St. Luke's Compliance Plan. READING - Intermediate: Ability to read and interpret documents such as operating and maintenance instructions and procedure manuals. WRITING - Intermediate: Ability to write routine reports, correspondence, or procedures. SPEAKING - Intermediate: Ability to effectively present information in one-on-one, small group situations or before groups of customers, clients, and other employees of the organization. MATHEMATICAL SKILLS - Basic Skills: Ability to add and subtract two-digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume, and distance. REASONING ABILITY - Intermediate Skills: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. AGE SPECIFIC COMPETENCIES - Skilled at assessment and knowledgeable of growth and development. Provides appropriate care respective to the ages of the patients served per clinical environment. PHYSICAL DEMANDS AND ENVIRONMENT PHYSICAL DEMANDS Stand - OccasionallyUnder 1/3(1-2.5 hours) Walk - OccasionallyUnder 1/3(1-2.5 hours) Sit - ContinuouslyOver 2/3(5.5 - 8 hours) Use hands to finger, handle, or feel - ContinuouslyOver 2/3(5.5 - 8 hours) Reach with hands and arms - OccasionallyUnder 1/3(1-2.5 hours) Stoop, squat, kneel, or crouch - OccasionallyUnder 1/3(1-2.5 hours) Bending-repetitive forward - OccasionallyUnder 1/3(1-2.5 hours) Talk or hear - ContinuouslyOver 2/3(5.5 - 8 hours) LIFTING REQUIREMENTS Up to 10 pounds - Frequently1/3 to 2/3(2.5 - 5.5 hours) Up to 25 pounds - OccasionallyUnder 1/3(1-2.5 hours) WORK ENVIRONMENT Typical Noise Level - Moderate noise (examples: business office with computers and printers, light traffic)