Rehab Admissions Liaison/Coordinator (PPS/CMS) (days)

We are seeking an Admissions Liaison/Coordinator, internally referred to as Prospective Payment Systems (PPS) Coordinator, in our Rehab Unit. The Admissions Liaison/Coordinator (PPS) is responsible for the management and oversight of prospective payment methodologies including Medicare and Medicaid reimbursement systems. This role ensures compliance with applicable regulations, optimizes reimbursement opportunities, and collaborates across departments to ensure accurate data collection, coding, and billing under PPS guidelines.

Shift's Available: Days

Employment Type: Full Time

Hours: 8-hour shift

Location: St. Mary's Medical Center, Blue Springs, MO

Here are some of the benefits of working at Prime Healthcare:

Health, dental, and vision insurance options
• Paid vacation, sick time and holidays
• Bereavement leave, FMLA and other leave options
• Employer 401K options
• Tuition reimbursement options
• Life, disability, and other insurance options
• Many other amazing benefits

Essential Duties and Responsibilities (includes, but not limited to):

• Knowledgeable and stays abreast of Medicare regulations affecting the Inpatient Rehabilitation Department, so appropriate reimbursement can be realized
• Coordinates, assesses, monitors and evaluates the IRF-PAI (Inpatient Rehab Facility-Patient Assessment Instrument) process, which determines a patient's RIC (Rehab Impairment Category), CMG (Case Mix Group) and payment under the rehabilitation Prospective Payment System and the outcome measurements
• Audits charts to assure competency with reimbursement guidelines
• Collaborate with coding, clinical documentation improvement (CDI), billing, and finance teams to optimize reimbursement and ensure regulatory compliance
• Educates and assures staff is certified in FIM assessing/scoring accurately
• Educates physicians on admission criteria and clinical documentation to support admission and reimbursement
• Functions as a vital member of the interdisciplinary team

Education and Work Experience

Before we go any further, we do have some deal-breakers. You must have:

• Graduate from an accredited School of Nursing, Physical Therapy, Occupational Therapy, Speech Pathology
• Bachelor's Degree in a health-related field: Health Administration, Finance, Nursing, or related field, or obtained within specified time of hire or equivalent experience
• 3 years of experience in healthcare reimbursement or Medicare/Medicaid payment systems.
• BLS thru the American Heart Association (AHA) certification upon hire and maintain current

Additional Qualifications That Are a Plus:

• RHIA, RHIT, or related coding/billing certification
• Master's Degree
• 3 years of experience in the rehab area
• Experience with data analysis and reporting tools; proficiency in Excel

Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/

We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

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