Northwell Health Validation Rev-Mixed Case Grp / Glen Cove / Full-Time, Day Shift in Glen Cove, New York

Req Number 0013GF

Job Category Case Management

Job Description

POSITION SUMMARY:

Coordinates assessment of patients and ensures compliance with Centers for Medicare and Medicaid Services (CMS). Plans, organizes, and evaluates the Rehabilitation Prospective Payment System Process. Assists with monitoring the process of rehab admission; development of the plan of care and patient discharge.

RESPONSIBILITIES:

  • Ensures completion of the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF PAI) for all IRF admissions according to CMS PPS schedules.

  • Ensures timely and accurate completion of the PPS instrument leading to appropriate reimbursement based on designated case mix group (CMG).

  • Reviews compliance threshold to ensure facility maintains IRF designation.

  • Reviews admissions, care of services provided, continued stays and discharge planning

  • Reviews documentation of all disciplines and care plans to ensure regulatory compliance.

  • Is knowledgeable and competent in FIM documentation.

  • Educates staff regarding completion of the PPS instrument, including each discipline’s specific responsibilities.

  • Reports deficient assessments to effect immediate improvement.

  • Develops quality improvement indicators related to PPS.

  • Submits required data electronically to CMS and other entities as directed.

  • Codes the medical record using ICD-10CM.

  • Electronically processes bill (UB-92) for reimbursement.

  • Participates in team conference and care plan meetings.

  • Performs related duties, as required.

Qualifications

  • Graduate from an accredited School of Nursing. Bachelor’s Degree in Nursing, preferred.

  • Current license to practice as a Registered Professional Nurse in New York State.

  • ICD-9CM required or ICD-10CM certification, preferred.

  • Minimum of three (3) years clinical experience, including acute inpatient rehabilitation experience, required.