About Shirley Ryan AbilityLab

Shirley Ryan AbilityLab is the global leader in physical medicine and rehabilitation for adults and children with the most severe, complex conditions. By joining our team, you will be part of our life-changing Mission and Vision. You’ll work in a truly inclusive environment where diversity and equity are championed through words and actions. You’ll contribute to an innovative culture that is second to none, one that embraces curiosity, discovery and compassion. You’ll play a role in something that’s never been done before as we integrate science and clinical care to help patients achieve better, faster outcomes — as we Advance Human Ability, together.

General Summary

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 – 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.

The PPS Coordinator will consistently demonstrate support of the Shirley Ryan AbilityLab statement of Vision, Mission and Core Values by striving for excellence, contributing to the team efforts and showing respect and compassion for patients and their families, fellow employees, and all others with whom there is contact at or in the interest of the institute.

The PPS Coordinator will demonstrate Shirley Ryan AbilityLab Core Attributes: Communication, Accountability, Flexibility/Adaptability, Judgment/Problem Solving, Customer Service and Core Values (Hope, Compassion, Discovery, Collaboration, and Commitment to Excellence) while fulfilling job duties.

Principal Responsibilities

The PPS Coordinator will:

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

Reporting Relationships

1. Reports directly to the PPS Process Specialist

Required Skills Required Experience

Knowledge, Skills & Abilities Required

1. A professional level of knowledge obtained by a Bachelor’s Degree or higher in a specialized field: Physical Therapy, Occupational Therapy, Therapeutic Recreation, Nursing or related field.
2. Current Illinois license/certification.
3. Minimum 3 years of relevant clinical experience in an inpatient rehabilitation setting.
4. Prior experience in a PPS role preferred
5. Exceptional organization, communication and interpersonal skills.
6. Excellent interpersonal skills along with strong problem solving abilities.
7. Ability to take ownership of serving the customer, team, and organization, of achieving goals and of resolving problems.
8. Ability to adapt to changing work demands and work environment.
9. Demonstrated critical thinking skills and ability to make sound judgments and respond to patient needs.
10. Ability to anticipate, assess, and address the needs of patients, and to influence the patient/customer experience.
11. Interpersonal skills; using verbal, non-verbal and written communication to provide information about expected rehab performance to patients and family members.
12. Proficiency knowledge of the Inpatient Patient Rehabilitation Facility Perspective Payment System
13. Proficiency in working with Cerner, eRehabData and CMS iQIES system programs.
14. Current basic working knowledge of Excel, Power Point, and Word applications

Working Conditions

1. Normal office environment with little or no exposure to dust or extreme temperature.
2. Includes Saturday, Sunday and Holiday rotation work.

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.

Shirley Ryan AbilityLab is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.