PPS Coordinator opportunity!
Our PPS Coordinator oversees, reviews and/or completes the PRI and MDS/PPS components of the facility based MDS/PPS/PRI/QI Program. Attends program education/training sessions for PRI certified assessors, assists with on sight completion/review for quarterly and full house PRI submissions. Completes all Medicare PPS MDS’s for both subacute and long-term care. Establishes the schedule for completion of the Medicare required assessments setting the completion date to maximize reimbursement and RUGS categories for each individual assessment. Acts as support/liaison to the Director of Nursing Services in determining eligibility for Medicare and tracking Medicare days in the facility. Consults with Clinical Management Systems Department regarding training and audit results. Serves as facility contact for third part payors to ensure coverage under the HMO contracts.
Registered Professional Nurse, licensed in New York State.
Certification in PRI Assessment and possession of a New York State PRI Assessor Number.
Knowledge of PRI/MDS/PPS software, completion, coding and submission requirements.
Adult teaching experience essential.
Excellent verbal and written communication skills.
Demonstrated knowledge of NYS Medicaid Program, RUGS II Classification Systems; Medicare/PPS Program, RUGS III Classification/Reimbursement Systems; ElderWood Medical Records Systems and documentation requirements.