Job Details

Reviews and ensures clinical documentation concurrently to ensure necessity for inpatient rehabilitation services and co-morbidities are appropriately and accurately identified and documented, meeting all appropriate CMS criteria and regulations for admission, concurrent stay and reimbursement. Evaluate potential admissions to ensure that they meet the requirements for admissions and ongoing audit and review of clinical documentation and treatment of patients. Performs various inpatient rehabilitation medical record reviews/audits, focusing on completion of documentation within the designated regulatory timeframes, physician attestation to the documents, meeting therapy participation requirements, accuracy and completeness of interdisciplinary team documentation. Plays a major role in documentation gathering, review and submission as it relates to CMS and other audits and ongoing projects such as RCD (Review Choice Demonstration Project). Reviews clinical documentation retrospectively as it relates to record requests, including external and internal audits as directed. Actively involved in education of physicians and interdisciplinary team to ensure documentation compliance and accuracy.

Job Description

Essential Functions:

• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
• Possess excellent interpersonal, communication, organizational skills, problem solving and critical thinking abilities, have good attention to detail and ability to work with interdisciplinary teams and independently. Reviews documentation on the rehabilitation inpatients, specifically for compliance and accuracy, both have an impact on regulatory compliance, reimbursement, and outcomes
• Utilizes computer skills to view EMR
• Works with interdisciplinary clinical teams to insure and improve documentation compliance with inpatient rehabilitation regulations and criteria. Performs other duties as assigned

Minimum Qualifications

• High School Diploma/GED and equivalent completion and certification through an accredited program.
• Computer, organizational, self-directed, detail oriented
• Skills in Windows Office programs (Word, Excel, and Power-point).
• Knowledge of Milliman and InterQual Criteria preferred; maintain knowledge of CMS Regulations and criteria as it pertains to acute inpatient rehabilitation.

Required:

• RN - Licensed Registered Nurse_NJ - State of New Jersey or
• RN - Licensed Registered Nurse_PA - State of Pennsylvania or
• OT - Licensed Occupational Therapist - State of Pennsylvania or
• PT - Licensed Physical Therapist - State of Pennsylvania or
• LPN - Licensed Practical Nurse_PA - State of Pennsylvania or
• LSW - Licensed Social Worker - State of Pennsylvania

Physical Demands
Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.

Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Magee Rehabilitation Hospital

Primary Location Address

1513 Race Street, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.    

Jefferson is committed to providing equal educa­tional and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status. 

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

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