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Job Description |
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The Program Coordinator in the Brain Injury unit will obtain appropriate/maximum reimbursement. Completes DRG coding by assigning ICD-9 diagnostic and procedure codes in accordance with the official coding guidelines established by the American Hospital Association. Completes CMG coding for Inpatient Rehab Facilities Prospective Payment System according to CMS guidelines. Educates physicians and clinical staff regarding accurate and complete documentation of services to reduce errors and omissions in coding for reimbursement. Performs data collection and auditing activities as they relate to CMS (Center for Medicare and Medicaid Services) Prospective Payment System. Identifies and facilitates opportunities for improvement in organizational performance. Assumes leadership/educational role on the interdisciplinary team. Maintains up-to-date knowledge of CMS changes or additions to the Prospective Payment System, CMS Conditions of Participation and Virginia Department of Medical Assistance (DMAS-Medicaid). - Licensure, Certification, or Registration Requirements for Hire
- Licensed as a Registered Nurse, Physical Therapist, Occupational Therapist, Speech and Language Pathologist or Clinical Social Worker in the Commonwealth of Virginia required. Licensed as a Registered Nurse in the Commonwealth of Virginia preferred.
- Rehabilitation Registered Nurse Certification (CRRN) preferred
- Licensure, Certification, or Registration Requirements for continued employment including CPR, etc
- Current RN, PT, OT, SLP or CSW license in the Commonwealth of Virginia required. Current license as a Registered Nurse preferred.
- CRRN certification preferred
- Level and type of experience REQUIRED
- Minimum of three (3) years of acute care and/or long term care work experience
- Previous experience with Medicare or CMS, PPS System, rehab unit admission and exclusion criteria
- Previous experience with Microsoft Office applications including MS Word and Excel
- Level and type of experience PREFERRED
- Previous experience with Functional Independence Measures (FIM) scoring and CMG coding
- Previous work experience with utilization review and coding
- Education/training REQUIRED
- Completion of an accredited school of professional nursing (RN), physical therapy, occupational therapy, speech and language pathology or clinical social work
- Describe independent action(s) required
- Interpretation of criteria for specific case application, concurrent intervention when opportunities for improvement are identified, prioritization of daily activities, and collaboration with interdisciplinary rehabilitation team. This position reports to the Rehabilitation Unit(s) Nurse Manager. The incumbent receives general direction from the Nurse Manager regarding implementing changes in procedures, overall criteria interpretation, clarifying business objectives and other related functions.
- Describe supervisory responsibilities (if applicable)
- Additional position requirements such as shift rotations, weekends, environment, etc
- Is expected to complete IRF-PAI forms for all CMS inpatient rehabilitation patients and submit to CMS within timeframes required. Hours of work are Monday-Friday from 8:00 a.m. to 4:30 p.m. with potential for some weekend hours for end of week admissions.
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