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Job Details
Reviews and insures 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. 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
• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
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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.
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Reviews documentation on the rehabilitation inpatients, specifically for compliance and accuracy, both have an impact on regulatory compliance, reimbursement, and outcomes
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Utilizes computer skills to view EMR
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Works with interdisciplinary clinical teams to insure and improve documentation compliance with inpatient rehabilitation regulations and criteria.
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Performs other duties as assigned
Education:
High School Diploma and equivalent completion and certification through an accredited program
of licensure requirements as listed below.
Experience:
Licensed in rehab role: IE RN, PT, OT, LPN, CCD, LSW
AND
Knowledge of Milliman and InterQual Criteria preferred
Manager - Please indicate minimum level of education and experience for this job.
Work Shift
Workday Day (United States of America)Worker Sub Type
RegularEmployee Entity
Albert Einstein Medical CenterPrimary Location Address
1200 Old York Road, Abington, Pennsylvania, United States of AmericaNationally 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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