Job Description

Overview

Your Career. Our Company. Together, We Grow.

At Southern Illinois Healthcare (SIH), we realize that in order to provide our surrounding communities with excellent care, we must begin by providing our employees with that same care and appreciation. We offer rich opportunities to develop and grow professionally, an environment of excellence in patient care, and the awareness that everything we accomplish is a direct outgrowth of the superb efforts and dedication of our employees.

As a non-profit system of almost 4000 employees, we have won national acclaim for our cancer, cardiac, stroke, bariatric, breast imaging, and rehabilitation services.

$55,598.00/yr minimum - $83,387.200/yr maximum (range increases based on education, experience and certifications)

Responsibilities

The Prospective Payment System Coordinator (PPS Coordinator) is responsible
for clinical data collection, entry, transmission and analysis, while ensuring
compliance with Medicare Prospective Payment System (PPS). The PPS
Coordinator reviews, collects and validates accuracy of data on the admission and
discharge IRF-PAI (Inpatient Rehabilitation Facility \xe2\x80\x93 Patient Assessment
Instrument) including Quality Indicator (QI) measures through review of medical
record supporting documentation and team discussion for assigned patients in
preparation for CMS submission for Medicare reimbursement. Facilitates
communications between the PPS processing team and practice areas to identify
appropriate documentation for patients. The PPS Coordinator serves as a leader
through consultation, collaboration and validation of the interdisciplinary PPS
documentation.
Principal Accountabilities

• Standards of Performance: Respect, Integrity, Compassion, Collaboration,

Stewardship, Accountability, Quality

Job Roles

• Safety

o Manages processes effectively in regard to employee/patient safety.

• Record Keeping

o Maintains all required records, reports, statistics, logs, files and other
documents as required.

• Process Improvement

o Promotes a culture of process improvement by participating in
unit/department based programs that supports the system\xe2\x80\x99s process
improvement goals.
o Actively participates on system-wide or hospital-based teams as needed.

• Role Specific Responsibilities

o Coordinate the data collection and accurately complete the IRF-PAI.
o Review and determine appropriate admission baseline and discharge
Quality Indicator (QI) measures for functional abilities based on
documentation supported in the patient record.
o Collaborate with clinical team members for any missing and/or errant
entries to resolve documentation discrepancies.
o Verify appropriate Case Mix Group (CMG) designation through chart
review along with coding and medical staff collaboration
o Transmit IRF-PAIs to Medicare and post assigned HIPPS codes in SIH
billing application
o Tracks and assist with denial management
o Track and evaluate QI audit changes and identify trends needing
improvement
o Prepare and discuss findings of SRALab outcome trends and National
Benchmarks with PPS Process Specialist and Innovation Teams/Leaders
o Provide training and mentoring to staff on the PPS process, including
Quality Indicator (QI) training
o Educate and coach staff on scoring discrepancies, measure definitions and
outcome opportunities
o Develops competency and educational development related to the IRFPAI
o Collaborate with Quality teams for accurate data collection of publicly
reported IRF-PAI items
o Perform all other duties assigned in the best interest of Southern Illinois
Healthcare

Qualifications

Education

• A professional level of knowledge obtained by a Bachelor\xe2\x80\x99s Degree or higher in a

specialized field: Physical Therapy, Occupational Therapy, Therapeutic
Recreation, Nursing or related field.
Licenses and Certification

• Current Illinois license/certification

Experience and Skills

• Minimum 3 years of relevant clinical experience in an inpatient rehabilitation

setting

• Exceptional organization, communication and interpersonal skills.
• Excellent interpersonal skills along with strong problem-solving abilities.
• Ability to take ownership of serving the customer, team, and organization, of

achieving goals and of resolving problems.

• Ability to adapt to changing work demands and work environment.
• Demonstrated critical thinking skills and ability to make sound judgments and

respond to patient needs.

• Ability to anticipate, assess, and address the needs of patients, and to influence the

patient/customer experience.

• Interpersonal skills; using verbal, non-verbal and written communication to

provide information about expected rehab performance to patients and family
members.

• Proficiency knowledge of the Inpatient Patient Rehabilitation Facility Perspective

Payment System

• Proficiency in working with Cerner, eRehabData and CMS iQIES system

programs.

• Current basic working knowledge of Excel, Power Point, and Word applications

Southern Illinois Healthcare