MDS PPS Specialist - Owensboro Health
Owensboro, KY 42303
About the Job
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.
Qualifications
- Associate's degree or higher or Diploma in Nursing required upon hire
- A minimum of 2 years' relevant experience required
- RN - Licensed as a Registered Nurse. Eligible to practice nursing in the State of Kentucky required upon hire
Skills and Attributes
- Requires critical thinking skills and decisive judgment.
- Works under minimal supervision.
- Must be able to work in a stressful environment and take appropriate action.
Physical Demands
- Standing: Occasionally
- Walking: Occasionally
- Sitting: Frequently
- Lifting 0-25 lbs: Rarely
- Lifting 25-75 lbs: Never
- Lifting over 75 lbs: Never
- Carrying 0-25 lbs: Rarely
- Carrying 25-75 lbs: Never
- Carrying over 75 lbs: Never
- Pushing/Pulling 0-25 lbs: Rarely
- Pushing/Pulling 25-75 lbs: Never
- Pushing/Pulling over 75 lbs: Never
- Climbing: Rarely
- Bending/Stooping: Rarely
- Kneeling: Rarely
- Crouching/Crawling: Rarely
- Reaching: Occasionally
- Talking: Frequently
- Hearing: Occasionally
- Repetitive Foot/Leg Movements: Never
- Repetitive Hand/Arm Movements: Frequently
- Keyboard Data Entry: Frequently
- Running: Never
- Vision: Depth Perception: Frequently
- Vision: Distinguish Color: Frequently
- Vision: Seeing Far: Frequently
- Vision: Seeing Near: Frequently
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.
Source : Owensboro Health