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Patient Assessment Coordinator - Houston, United States - Hope Community Resources, Inc
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Description
Patient Assessment Coordinator
Using discretion and independent judgment, the Patient Assessment Coordinator coordinates the process of providing accurate and timely data to the appropriate entities involved in the Prospective Payment System and quality reporting program for Medicare patients. This position oversees all aspects of data collection on the IRF/PAI, ensures the presence of supporting documentation, and provides staff education to ensure compliance with CMS guidelines. The Coordinator assumes the task of reviewing each IRF/PAI form completely, accurately, and timely. He or she also monitors the accuracy in the scoring of the functional status and reflection of the patient's care needs and inputs appropriate information for the IRF/PAI into the eRehabData system. This role is also responsible for coordinating the collection of patient information from the patient medical record and the completion of assigned sections of the IRF/PAI form. Additional responsibilities include: setting proscribed IRF/PAI completion dates for the multi-disciplinary team; developing and interpreting policies and procedures; acting as the primary resource for immediate problem-solving in regards to Medicare's IRF prospective payment system (FIM scoring, impairment group coding, tiering distribution); coverage and classification criteria; and quality reporting program requirements.
RESPONSIBILITIES
Responsibilities
• Thoroughly researches clinical documentation for evidence of co-morbid conditions. Verifies accuracy of coding under direction of the attending Physical Medicine and Rehabilitation physician.
• Responsible for staff education to improve FIM scoring process, documentation and accuracy.
• Reviews clinical documentation and makes recommendations to clinical supervisors in areas needing improvement to support and validate compliance with rehab coverage and classification criteria.
• Oversees, completes, and ensures the accuracy and the completion of the IRF/PAI prior to electronic transmission.
• Serves as an information source and educator to IRF/PAI users.
• Collaborates with physicians and interdisciplinary team members to ensure accurate clinical assessment with supporting documentation to accurately report medical and functional status of patients.
• Maintains current knowledge of IRF/PAI software and provides expertise on this software within the inpatient setting.
• Provides ongoing education to the staff of the hospital to ensure accurate and timely completion of the IRF/PAI.
• Maintains updated and ongoing knowledge of the regulations concerning the IRF/PAI and its completion within the inpatient setting.
• Verifies appropriate CMG designation through chart review, staff interview, collaboration with physicians and coders.
• Coordinates the completion of the admission assessment of the PAI by the fourth (4th) day of the patient's stay and the fifth (5th) day following discharge for each inpatient stay. May require discussions/interactions with various staff members concerning differences in reported functional status to complete the PAI.
• Transmits the IRF/PAI to CMS within the required timeframe.
• Ensures that the IRF/PAI reflects the functional status and 24-hour care needs of the patient.
• Ensures accuracy of data on the IRF/PAI to correctly reflect the quality reporting program requirements.
• Periodically audits the IRF/PAI, clinical documentation, and billing information to ensure accuracy and consistency of documentation.
• Assists the Clinical Director in identifying and monitoring trends in patient care as identified through the PAI.
• Works closely and collaboratively with all members of the clinical and coding team to ensure compliance at all levels.
• Demonstrates effective critical thinking skills.
Professional Requirements
• Maintains regulatory requirements, including all state, federal, Joint Commission, and hospital compliance plans.
• Maintains cooperative working relationship and good rapport with medical staff, hospital departments and staff, and other organizations or entities related to hospital business.
• Represents the organization in a positive and professional manner.
• Communicates the mission, ethics, and goals of the organization at all levels of the organization.
• Clearly and effectively communicates with all constituents (patients, families, peers, and other healthcare team members) as needed for leadership, assessment, intervention, and professional development.
QUALIFICATIONS
Licenses/Certifications: Graduate of an accredited OT, PT, SLP, or RN (CRRN preferred) program with current licensure in the state in which facility resides. ASN required; Bachelor's degree preferred for nursing. Master's degree required for OT/PT/SLP. Current Basic Life Support (BLS)/CPR card. A minimum of three (3) to five (5) years of experience in a patient assessment coordinator role may be substituted for degree and license.
Experience: Three (3) to five (5) years of experience in the care of patients in an acute hospital, rehabilitation, or LTACH setting required.
Knowledge, Skills, and Abilities:
• Demonstrated knowledge of acute rehab criteria, LTACH criteria, level of care requirements, and medical necessity.
• Understands medical terminology, regulations and parameters of third-party reimbursements, and coding guidelines.
• Basic computer knowledge including Outlook, Excel, PowerPoint, Word and data management software required.
• Strong interpersonal skills.
• Excellent written and verbal communication skills.
ABOUT US
PAM Health is committed to being the most trusted source for post-acute services in every community it serves by utilizing experienced and dedicated staff to provide high quality patient care and customer service. With over 44 Long Term Acute Care and Rehabilitation hospitals and 16 Outpatient Clinics currently in operation across the country, we are proud to offer services including comprehensive wound care, aquatic therapy, ventilator weaning, amputation treatment, pain management and much more.
Joining our PAMily allows you to work in a collaborative environment with colleagues and leadership with exposure to a variety of patient care levels. Aside from our competitive pay, generous paid benefit time, and excellent insurance options, you will also have opportunities for professional growth through our Education Advancement Program.
PAM Health does not discriminate and does not permit discrimination, including, without limitation, bullying, abuse or harassment, on the basis of actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status, or based on association with another person on account of that person's actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status.