MDS PPS Specialist - Transitional Care
- 1000 Owensboro Health, Inc.
- Owensboro Health Regional Hospital
- 7mo ago
- Full-Time
- On-site
Job Summary:
Responsible for the timely preparing, filing, and tracking required Center for Medicare and Medicaid Services (CMS) documents for all Medicare patients on the Transitional Care Unit and oversees all aspects of data collection on the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI).
Job Responsibilities:
Documents clinical assessment of patients and sends electronically to the Center for Medicare and Medicaid Services (CMS) in mandatory specified time frames.
Responsible for clinical data collection, entry, transmission, and analysis to ensure compliance with the requirements of the Medicare Prospective Payment System.
Provides on-going education to physicians, nursing staff, ancillary staff, and support staff regarding CMS, state, and other regulatory agencies.
Provides periodic and on-going Functional Independence Measure (FIM) training for nurses, therapist, and physicians; provides training for mandatory FIM credentialing by rehabilitation clinicians.
Maintains current knowledge of Resident Assessment Instrument (RAI) Manual and Minimum Data Set (MDS) assessment process.
Monitors completion of MDSs by other disciplines within time frames prescribed by regulatory guidelines.
Performs IRF-PAI data collection and review for completeness, accuracy, consistency, and reliability.
Assists in the development of a comprehensive resident assessment and care plan.
Utilizes critical thinking skills to select the correct reason for assessment and Assessment Reference Date (ARD); participates in the minute management process.
Monitors patient charts for correct coding, electronically transmits data, and communicates with a multidisciplinary team to create and carry out patient treatment plans. Monitors and audits clinical record documentation on assigned residents to ensure accuracy and timeliness.
Monitors program compliance and changes with Medicare Services.
Coordinates the development and completion of the resident assessment MDS for all residents assigned in accordance with all federal and state guidelines.
Coordinates the process of providing accurate and timely data to the appropriate entities involved in the Prospective Payment System for Medicare patients.
Coordinates all patient information to be submitted to CMS for Medicare reimbursement.
Ensures that the care/services provided are captured accurately and appropriate payment is received by the Medicare/Medicaid systems.
Ensures that admission, weekly, and discharge FIM scores are documented in the medical record and available for weekly Team Conferences.
Selects the correct ARD and correct reasons for assessment that capture all resources to ensure appropriate payment by Medicare/Medicaid systems.
Successful completion of functional assessment training and testing.
Skills and Attributes:
Requires critical thinking skills and decisive judgment.
Works under direct supervision.
Must be able to work in a stressful environment and take appropriate action.
Position Requirements:
Work Experience
A minimum of 2 years' relevant experience required
Education
Bachelor’s degree or higher in Nursing required within 5 years of employment in this position.
Licensure/Certification/Registration
RN - Licensed as a Registered Nurse. Eligible to practice nursing in the State of Kentucky required upon hire
Organizational Responsibilities:
Supports Owensboro Health’s Mission, Vision, Core Commitments, and business interests. Adheres to all organizational policies and procedures. Executes all tasks and behaves in a manner consistent with a culture of compliance, safety and a high reliability organization.
Additional Job Information:
This job description describes the general nature and level of work required by the position. It is not intended to be an all-inclusive list of qualifications, skills, duties, responsibilities or working conditions of the job. Specific duties and responsibilities consistent with the general nature and level of work described may vary by department and additional related duties may be assigned as needed. Some duties listed may not apply to all employees with this job description.
The job description is subject to change with or without notice, and Management reserves the right to add, modify or remove any qualification or duty. Nothing in this job description changes the existing at-will employment relationship between the Organization and the employee occupying the position.
Standard ADA Settings:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Physical Demands: (Office Environment)
Standing: 75%
Walking: 75%
Sitting: 50%
Lifting 0-25 lbs: 25%
Lifting 25-75 lbs: 25%
Lifting over 75 lbs: 25%
Carrying 0-25 lbs: 25%
Carrying 25-75 lbs: 25%
Carrying over 75 lbs: 25%
Pushing/Pulling 0-25 lbs: 75%
Pushing/Pulling 25-75 lbs: 50%
Pushing/Pulling over 75 lbs: 50%
Climbing: 50%
Bending/Stooping: 75%
Kneeling: 50%
Crouching/Crawling: 50%
Reaching: 75%
Talking: 75%
Hearing: 75%
Repetitive Foot/Leg Movements: 25%
Repetitive Hand/Arm Movements: 75%
Keyboard Data Entry: 75%
Running: 25%
Vision: Depth Perception: 75%
Vision: Distinguish Color: 75%
Vision: Seeing Far: 75%
Vision: Seeing Near: 75%
Hazardous Drug Risk Exposure:
Risk Level: No-Risk
Owensboro Health Core Commitments
INTEGRITY - We conduct ourselves with a high level of responsibility, reliability and honesty because we take seriously the trust of our patients and coworkers.
RESPECT - We value and accept the unique talents and contributions of every patient, customer and team member in the Owensboro Health community.
TEAMWORK - We build a spirit of connectivity and fellowship by striving together to overcome obstacles, surpass goals, celebrate accomplishments and plan the future.
INNOVATION - We foster original ideas and creative solutions that improve our daily work and promote the mission of Owensboro Health.
SERVICE - We focus on service to patients, customers and team members by anticipating their needs, thoughtfully meeting those needs and continually improving the quality of everything we do.
EXCELLENCE - We reach beyond basic expectations to expand our knowledge and awareness, produce exceptional work and provide outstanding service.