Prospective Payment System (PPS) Coordinator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now!
WVU Medicine
Prospective Payment System (PPS) Coordinator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now!
Job Description
Role Overview
The Prospective Payment System (PPS) Coordinator at WVU Medicine's Ruby Memorial Hospital plays a crucial role in ensuring the accuracy and compliance of inpatient rehabilitation services. This position involves the planning, development, and coordination of activities that support the PPS process for the inpatient rehabilitation unit. The coordinator is responsible for overseeing the completion and transmission of the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI), ensuring compliance with all state and federal requirements. This role demands a meticulous approach to data management, a thorough understanding of healthcare regulations, and excellent communication skills.A Day in the Life
A typical day for the PPS Coordinator involves several key tasks. First, the coordinator reviews patient charts to collect pertinent demographic, clinical, and care set data for entry into the IRF-PAI. They collaborate with the rehab liaison, case manager, and admitting physician to determine the appropriate case mix group (CMG) for each patient. The coordinator ensures that the Preadmission Screen (PASE) is completed and signed within 48 hours of admission and that the HPI (History of Present Illness) and Individualized Overall Plan of Care meet CMS requirements. Throughout the day, the coordinator tracks and monitors the intense level of rehabilitation services and individualized care provided to patients. They communicate with coders to determine etiologic diagnoses and co-morbid conditions present on admission. They also participate in care conferences, reviewing documentation concurrently to ensure accurate capture of team conference discussions. The coordinator tracks and reports regularly on 60% rule compliance, staying updated on changes to CMS and PPS regulations. Staff education is another critical aspect of the role. The PPS Coordinator provides ongoing training to staff, including physicians, nurses, and therapists, to ensure compliance with CMS guidelines. They also coordinate data analysis and quality improvement opportunities with the rehab leadership team to enhance the efficiency and accuracy of the PPS process.Why Morgantown, West Virginia?
Morgantown, West Virginia, offers a unique blend of small-town charm and big-city amenities. As the home of West Virginia University, Morgantown has a vibrant cultural scene with numerous arts and entertainment options. The city boasts a low cost of living compared to many other metropolitan areas, making it an attractive place to live and work. The surrounding area offers ample opportunities for outdoor recreation, including hiking, biking, and water sports. Morgantown is also conveniently located within driving distance of major cities like Pittsburgh and Washington, D.C. Working at WVU Medicine in Morgantown provides access to a leading healthcare system with state-of-the-art facilities and a supportive work environment. Employees enjoy a competitive salary and benefits package, as well as opportunities for professional growth and development. WVU Medicine is committed to providing high-quality care to the community, and employees play a vital role in fulfilling this mission.Career Path
The PPS Coordinator role can serve as a stepping stone to various career paths within WVU Medicine. With experience and further education, the coordinator could advance to positions such as: Data Analytics Manager, Compliance Officer, Rehabilitation Services Manager, or Healthcare Consultant. The skills and knowledge gained in this role, including data analysis, regulatory compliance, and staff education, are highly transferable and valuable in various healthcare settings.Salary & Benefits
The estimated salary range for the PPS Coordinator position at WVU Medicine in Morgantown, West Virginia, is between $48,000 and $68,000 per year. The exact salary will depend on factors such as experience, education, and certifications. WVU Medicine offers a comprehensive benefits package, including health insurance (medical, dental, vision), paid time off (PTO), retirement plan options with employer matching, life insurance, disability insurance, employee assistance program (EAP), tuition reimbursement, and more.WVU Medicine Culture
WVU Medicine is committed to creating a culture of excellence, teamwork, and patient-centered care. Employees are valued for their contributions and are encouraged to participate in professional development opportunities. The organization fosters a supportive work environment where employees can grow and thrive. WVU Medicine is dedicated to providing high-quality care to the community and is actively involved in various community outreach programs.How to Apply
To apply for the PPS Coordinator position at WVU Medicine, please click the "Apply" button located at the top of this page. Complete the application in full, providing accurate and detailed information about your qualifications and experience. Be sure to attach your resume and any relevant certifications. If you have any questions about the application process, please contact the WVU Medicine HR department.FAQ
- What are the minimum qualifications for this position?
- High School Diploma or equivalent.
- BLS Certification within 30 days of hire.
- Two (2) years healthcare experience.
- Is experience with IRF-PAI required?
- Experience with the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF PAI) and Uniform Data System (UDS) is preferred.
- What are the main responsibilities of the PPS Coordinator?
- Completing and transmitting the IRF-PAI to CMS, ensuring accuracy and compliance, and providing staff education on CMS guidelines.
- What type of benefits does WVU Medicine offer?
- WVU Medicine offers a comprehensive benefits package, including health insurance, paid time off, retirement plans, and tuition reimbursement.
- What is the work environment like at WVU Medicine?
- WVU Medicine fosters a supportive and collaborative work environment focused on patient-centered care.
- What opportunities for professional development are available?
- WVU Medicine provides various professional development opportunities, including tuition reimbursement and training programs.
- How does the PPS Coordinator contribute to quality improvement?
- The PPS Coordinator coordinates data analysis and identifies opportunities to improve the accuracy and efficiency of the PPS process.
- What is the significance of the 60% rule?
- The 60% rule is a CMS regulation related to the types of patients that must be treated in an inpatient rehabilitation facility to maintain compliance.
- How does the coordinator collaborate with other healthcare professionals?
- The coordinator works closely with physicians, nurses, therapists, case managers, and coders to ensure accurate documentation and care coordination.
- What is the importance of staying updated on CMS regulations?
- Staying updated on CMS regulations is crucial for ensuring compliance and maintaining the facility's eligibility for participation in the Prospective Payment System.
Locations
- Morgantown, West Virginia, United States
Salary
Estimated Salary Rangemedium confidence
52,800 - 74,800 USD / yearly
Source: ai estimated
* This is an estimated range based on market data and may vary based on experience and qualifications.
Skills Required
- Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI)intermediate
- Uniform Data System (UDS)intermediate
- Prospective Payment System (PPS)intermediate
- CMS Regulationsintermediate
- Data Analysisintermediate
- Quality Improvementintermediate
- Staff Educationintermediate
- Interdisciplinary Collaborationintermediate
- Care Plan Developmentintermediate
- Documentationintermediate
- Coding (ICD-10, etc.)intermediate
- Case Managementintermediate
- Discharge Planningintermediate
- Complianceintermediate
- Communicationintermediate
- Electronic Transmissionintermediate
- Healthcare Regulationsintermediate
Required Qualifications
- High School Diploma or equivalent (experience)
- BLS Certification within 30 days of hire (experience)
- Two (2) years healthcare experience (experience)
- Experience with Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF PAI) and Uniform Data System (UDS) preferred (experience)
- Knowledge of CMS and PPS regulations (experience)
- Understanding of medical terminology (experience)
- Familiarity with ICD-10 coding (experience)
- Experience with data entry and analysis (experience)
- Strong organizational skills (experience)
- Excellent communication skills, both written and verbal (experience)
- Ability to work independently and as part of a team (experience)
- Proficiency in Microsoft Office Suite (experience)
- Ability to prioritize tasks and meet deadlines (experience)
- Knowledge of healthcare compliance standards (experience)
- Understanding of rehabilitation services and patient care (experience)
Responsibilities
- Completes and transmits the IRF-PAI to CMS accurately and within required timeframes.
- Oversees and ensures the accuracy and completion of the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) prior to electronic transmission.
- Maintains a current knowledge of IRF-PAI software and provides expertise on this software within the inpatient rehab setting.
- Collaborates with rehab liaison/case manager and admitting physician to determine the anticipated case mix group (CMG) to be assigned to each patient admitted.
- Collects pertinent demographic, clinical, and care set data and enters it on the IRF-PAI.
- Ensures Preadmission Screen is completed (PASE) and signed within 48 hours of IRF admit.
- Ensures HPI completed as required for IRF documentation and as required under the conditions of participation.
- Ensures Individualized Overall Plan of Care includes CMS required documentation and is completed within 4 days of IRF admit.
- Tracks, monitors, and reports Intense Level of Rehabilitation Services and individualized care.
- Communicates with coders within 4 days of admission to determine etiologic diagnosis and co-morbid conditions present on admission.
- Communicates estimated length of stay and expected outcomes to the team and to the case manager for discharge planning and discussion at case conference.
- Participates in all care conferences and reviews documentation concurrently throughout the stay to ensure accurate documentation of team conference discussion. Reviews codes as provided by health information management for capture of documented conditions.
- Tracks and reports regularly on 60% rule compliance.
- Maintains a current knowledge of CMS and PPS regulations related to participation requirements for inpatient rehabilitation facilities.
- Provides ongoing staff education to ensure compliance with CMS guidelines.
- Assists with formulating a plan of care including expected outcomes for each patient based on diagnoses derived from patient assessments.
- Educates and trains staff, including physicians, nurses, and therapists, on proper documentation and coding procedures.
- Coordinates data analysis and quality improvement opportunities with the rehab leadership team.
- Monitors key performance indicators related to PPS and IRF-PAI compliance.
- Identifies and implements strategies to improve data accuracy and efficiency.
- Participates in audits and reviews of IRF-PAI documentation.
- Serves as a resource for staff regarding PPS and IRF-PAI requirements.
- Stays up-to-date on changes to CMS regulations and guidelines.
- Works with IT department to troubleshoot issues with IRF-PAI software.
Benefits
- general: Comprehensive health insurance (medical, dental, vision)
- general: Paid time off (PTO) including vacation, sick leave, and holidays
- general: Retirement plan options with employer matching
- general: Life insurance
- general: Disability insurance (short-term and long-term)
- general: Employee assistance program (EAP)
- general: Tuition reimbursement
- general: Professional development opportunities
- general: Wellness programs
- general: Employee discounts
- general: On-site childcare (availability may vary)
- general: Flexible spending accounts (FSA)
- general: Health savings accounts (HSA)
- general: Relocation assistance (if applicable)
- general: Sign-on bonus (if applicable)
- general: Competitive salary
- general: Supportive work environment
- general: Opportunities for advancement
- general: Commitment to work-life balance
- general: Recognition programs
- general: Community involvement opportunities
Tags & Categories
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Prospective Payment System (PPS) Coordinator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now!
WVU Medicine
Prospective Payment System (PPS) Coordinator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now!
Job Description
Role Overview
The Prospective Payment System (PPS) Coordinator at WVU Medicine's Ruby Memorial Hospital plays a crucial role in ensuring the accuracy and compliance of inpatient rehabilitation services. This position involves the planning, development, and coordination of activities that support the PPS process for the inpatient rehabilitation unit. The coordinator is responsible for overseeing the completion and transmission of the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI), ensuring compliance with all state and federal requirements. This role demands a meticulous approach to data management, a thorough understanding of healthcare regulations, and excellent communication skills.A Day in the Life
A typical day for the PPS Coordinator involves several key tasks. First, the coordinator reviews patient charts to collect pertinent demographic, clinical, and care set data for entry into the IRF-PAI. They collaborate with the rehab liaison, case manager, and admitting physician to determine the appropriate case mix group (CMG) for each patient. The coordinator ensures that the Preadmission Screen (PASE) is completed and signed within 48 hours of admission and that the HPI (History of Present Illness) and Individualized Overall Plan of Care meet CMS requirements. Throughout the day, the coordinator tracks and monitors the intense level of rehabilitation services and individualized care provided to patients. They communicate with coders to determine etiologic diagnoses and co-morbid conditions present on admission. They also participate in care conferences, reviewing documentation concurrently to ensure accurate capture of team conference discussions. The coordinator tracks and reports regularly on 60% rule compliance, staying updated on changes to CMS and PPS regulations. Staff education is another critical aspect of the role. The PPS Coordinator provides ongoing training to staff, including physicians, nurses, and therapists, to ensure compliance with CMS guidelines. They also coordinate data analysis and quality improvement opportunities with the rehab leadership team to enhance the efficiency and accuracy of the PPS process.Why Morgantown, West Virginia?
Morgantown, West Virginia, offers a unique blend of small-town charm and big-city amenities. As the home of West Virginia University, Morgantown has a vibrant cultural scene with numerous arts and entertainment options. The city boasts a low cost of living compared to many other metropolitan areas, making it an attractive place to live and work. The surrounding area offers ample opportunities for outdoor recreation, including hiking, biking, and water sports. Morgantown is also conveniently located within driving distance of major cities like Pittsburgh and Washington, D.C. Working at WVU Medicine in Morgantown provides access to a leading healthcare system with state-of-the-art facilities and a supportive work environment. Employees enjoy a competitive salary and benefits package, as well as opportunities for professional growth and development. WVU Medicine is committed to providing high-quality care to the community, and employees play a vital role in fulfilling this mission.Career Path
The PPS Coordinator role can serve as a stepping stone to various career paths within WVU Medicine. With experience and further education, the coordinator could advance to positions such as: Data Analytics Manager, Compliance Officer, Rehabilitation Services Manager, or Healthcare Consultant. The skills and knowledge gained in this role, including data analysis, regulatory compliance, and staff education, are highly transferable and valuable in various healthcare settings.Salary & Benefits
The estimated salary range for the PPS Coordinator position at WVU Medicine in Morgantown, West Virginia, is between $48,000 and $68,000 per year. The exact salary will depend on factors such as experience, education, and certifications. WVU Medicine offers a comprehensive benefits package, including health insurance (medical, dental, vision), paid time off (PTO), retirement plan options with employer matching, life insurance, disability insurance, employee assistance program (EAP), tuition reimbursement, and more.WVU Medicine Culture
WVU Medicine is committed to creating a culture of excellence, teamwork, and patient-centered care. Employees are valued for their contributions and are encouraged to participate in professional development opportunities. The organization fosters a supportive work environment where employees can grow and thrive. WVU Medicine is dedicated to providing high-quality care to the community and is actively involved in various community outreach programs.How to Apply
To apply for the PPS Coordinator position at WVU Medicine, please click the "Apply" button located at the top of this page. Complete the application in full, providing accurate and detailed information about your qualifications and experience. Be sure to attach your resume and any relevant certifications. If you have any questions about the application process, please contact the WVU Medicine HR department.FAQ
- What are the minimum qualifications for this position?
- High School Diploma or equivalent.
- BLS Certification within 30 days of hire.
- Two (2) years healthcare experience.
- Is experience with IRF-PAI required?
- Experience with the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF PAI) and Uniform Data System (UDS) is preferred.
- What are the main responsibilities of the PPS Coordinator?
- Completing and transmitting the IRF-PAI to CMS, ensuring accuracy and compliance, and providing staff education on CMS guidelines.
- What type of benefits does WVU Medicine offer?
- WVU Medicine offers a comprehensive benefits package, including health insurance, paid time off, retirement plans, and tuition reimbursement.
- What is the work environment like at WVU Medicine?
- WVU Medicine fosters a supportive and collaborative work environment focused on patient-centered care.
- What opportunities for professional development are available?
- WVU Medicine provides various professional development opportunities, including tuition reimbursement and training programs.
- How does the PPS Coordinator contribute to quality improvement?
- The PPS Coordinator coordinates data analysis and identifies opportunities to improve the accuracy and efficiency of the PPS process.
- What is the significance of the 60% rule?
- The 60% rule is a CMS regulation related to the types of patients that must be treated in an inpatient rehabilitation facility to maintain compliance.
- How does the coordinator collaborate with other healthcare professionals?
- The coordinator works closely with physicians, nurses, therapists, case managers, and coders to ensure accurate documentation and care coordination.
- What is the importance of staying updated on CMS regulations?
- Staying updated on CMS regulations is crucial for ensuring compliance and maintaining the facility's eligibility for participation in the Prospective Payment System.
Locations
- Morgantown, West Virginia, United States
Salary
Estimated Salary Rangemedium confidence
52,800 - 74,800 USD / yearly
Source: ai estimated
* This is an estimated range based on market data and may vary based on experience and qualifications.
Skills Required
- Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI)intermediate
- Uniform Data System (UDS)intermediate
- Prospective Payment System (PPS)intermediate
- CMS Regulationsintermediate
- Data Analysisintermediate
- Quality Improvementintermediate
- Staff Educationintermediate
- Interdisciplinary Collaborationintermediate
- Care Plan Developmentintermediate
- Documentationintermediate
- Coding (ICD-10, etc.)intermediate
- Case Managementintermediate
- Discharge Planningintermediate
- Complianceintermediate
- Communicationintermediate
- Electronic Transmissionintermediate
- Healthcare Regulationsintermediate
Required Qualifications
- High School Diploma or equivalent (experience)
- BLS Certification within 30 days of hire (experience)
- Two (2) years healthcare experience (experience)
- Experience with Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF PAI) and Uniform Data System (UDS) preferred (experience)
- Knowledge of CMS and PPS regulations (experience)
- Understanding of medical terminology (experience)
- Familiarity with ICD-10 coding (experience)
- Experience with data entry and analysis (experience)
- Strong organizational skills (experience)
- Excellent communication skills, both written and verbal (experience)
- Ability to work independently and as part of a team (experience)
- Proficiency in Microsoft Office Suite (experience)
- Ability to prioritize tasks and meet deadlines (experience)
- Knowledge of healthcare compliance standards (experience)
- Understanding of rehabilitation services and patient care (experience)
Responsibilities
- Completes and transmits the IRF-PAI to CMS accurately and within required timeframes.
- Oversees and ensures the accuracy and completion of the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) prior to electronic transmission.
- Maintains a current knowledge of IRF-PAI software and provides expertise on this software within the inpatient rehab setting.
- Collaborates with rehab liaison/case manager and admitting physician to determine the anticipated case mix group (CMG) to be assigned to each patient admitted.
- Collects pertinent demographic, clinical, and care set data and enters it on the IRF-PAI.
- Ensures Preadmission Screen is completed (PASE) and signed within 48 hours of IRF admit.
- Ensures HPI completed as required for IRF documentation and as required under the conditions of participation.
- Ensures Individualized Overall Plan of Care includes CMS required documentation and is completed within 4 days of IRF admit.
- Tracks, monitors, and reports Intense Level of Rehabilitation Services and individualized care.
- Communicates with coders within 4 days of admission to determine etiologic diagnosis and co-morbid conditions present on admission.
- Communicates estimated length of stay and expected outcomes to the team and to the case manager for discharge planning and discussion at case conference.
- Participates in all care conferences and reviews documentation concurrently throughout the stay to ensure accurate documentation of team conference discussion. Reviews codes as provided by health information management for capture of documented conditions.
- Tracks and reports regularly on 60% rule compliance.
- Maintains a current knowledge of CMS and PPS regulations related to participation requirements for inpatient rehabilitation facilities.
- Provides ongoing staff education to ensure compliance with CMS guidelines.
- Assists with formulating a plan of care including expected outcomes for each patient based on diagnoses derived from patient assessments.
- Educates and trains staff, including physicians, nurses, and therapists, on proper documentation and coding procedures.
- Coordinates data analysis and quality improvement opportunities with the rehab leadership team.
- Monitors key performance indicators related to PPS and IRF-PAI compliance.
- Identifies and implements strategies to improve data accuracy and efficiency.
- Participates in audits and reviews of IRF-PAI documentation.
- Serves as a resource for staff regarding PPS and IRF-PAI requirements.
- Stays up-to-date on changes to CMS regulations and guidelines.
- Works with IT department to troubleshoot issues with IRF-PAI software.
Benefits
- general: Comprehensive health insurance (medical, dental, vision)
- general: Paid time off (PTO) including vacation, sick leave, and holidays
- general: Retirement plan options with employer matching
- general: Life insurance
- general: Disability insurance (short-term and long-term)
- general: Employee assistance program (EAP)
- general: Tuition reimbursement
- general: Professional development opportunities
- general: Wellness programs
- general: Employee discounts
- general: On-site childcare (availability may vary)
- general: Flexible spending accounts (FSA)
- general: Health savings accounts (HSA)
- general: Relocation assistance (if applicable)
- general: Sign-on bonus (if applicable)
- general: Competitive salary
- general: Supportive work environment
- general: Opportunities for advancement
- general: Commitment to work-life balance
- general: Recognition programs
- general: Community involvement opportunities
Tags & Categories
Answer 10 quick questions to check your fit for Prospective Payment System (PPS) Coordinator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now! @ WVU Medicine.
10 Questions
~2 Minutes
Instant Score
Related Books and Jobs