Prospective Payment Coordinator

Company: Intermountain Health
Location: Grand Junction
Posted on: December 2, 2025

Job Description:

Job Description: This onsite position oversees all aspects of data collection for the Inpatient Rehab Facility-Patient Assessment Instrument (IRF-PAI), ensuring the presence of supporting documentation and associated assignment of accurate and defendable impairment and Case Mix Group (CMG) code assignment. The Prospective Payment System Coordinator (PPS) ensures accurate scoring of functional status in accordance with Center for Medicare & Medicaid Services (CMS) guidelines. In addition, the PPS Coordinator acts as primary resource for immediate problem solving in regard to Inpatient Rehabilitation (IRF) data needs. This position primarily supports the IRF unit in a given facility, has system-wide responsibilities and provides back-up for other PPS Coordinators within the system during leave or times of higher volumes. Incumbents work primarily during regular business hours in order to maximize interaction and teaching opportunities with clinical staff. Schedule - Monday - Friday 8:00 am - 5:00 pm with an o ccasional weekend or holiday work may surface. Essential Functions Provides concurrent review of medical record to ensure documentation meets quality standards and includes an accurate reflection of the patient's status including timely, accurate, and complete documentation of clinical information. Facilitates modifications to clinical documentation through extensive concurrent interactions with physicians, therapists, nursing staff, coding and other clinical staff as needed, to support appropriate reimbursement and ensure clinical severity is captured. Identifies opportunities where additional provider documentation is required to thoroughly and accurately assign Etiological Diagnosis, Impairment Group, CMG, comorbidities and complete IRF-PAI. Coordinates and performs timely abstraction of required data elements, including submission of IRF-PAI data to Uniform Data Systems (UDS) and other databases, as needed. Provides staff education and training for Quality Indicator requirements and w orks collaboratively with unit leaders, providers, nurses, therapists, and coding to ensure accurate data reporting. Provides coordination of clinical documentation for submission to CMS and/or other auditors, as needed. Maintains knowledge of current Medicare rules pertaining to the IRF including the annual final rule and related communications. Reviews and validates data for CMS Provider Review Reports and requests corrections, if necessary. Works collaboratively with clinicians, DTS, and others to develop data collection tools for IRF-PAI and other CMS reported data. Supports Team Conferences by preparing documentation for scheduled patients as well as attending the meetings to provide insight related to estimated length of stay, key metrics and data related to the stay. Skills Verbal and Written Communication Versatility Interpersonal Communication Critical Thinking Decision Making Detail Oriented Time Management Quality Improvement Adaptability Active Listening Dependability Compassion Qualifications Minimum Strong written and verbal communication skills. Demonstrated sound judgment, organization, analytical, and decision-making skills. Experience in a role requiring attention to detail while meeting tight deadlines. Demonstrated intermediate computer skills in word processing, database management and spreadsheets. Work experience in healthcare. Meet qualifications for PPS Certification within two years of hire and maintains certification. ? Preferred A bachelor’s or master’s degree in a related field Prior work experience as a Prospective Payment Coordinator Working knowledge of ICD-10 coding principles and/or IRF PAI requirements Work experience on an inpatient rehabilitation unit Clinical license as a nurse, physical, occupational or speech-language therapist Strong experience with EPIC Strong experience with data management, analysis, quality improvement Experience with training and educating others, detail oriented and a self-starter with project management Physical Requirements: Physical Requirements Ongoing need for employee to see and read information and documents Frequent interactions with providers, colleagues, nurses, therapists and regulatory personnel, that requires employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately. Manual dexterity of hands and fingers to manipulate for frequent computer use for typing, accessing needed information, etc. Sitting and/or standing tolerance Location: St. Marys Regional Hospital Work City: Grand Junction Work State: Colorado Scheduled Weekly Hours: 40 The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $42.66 - $65.82 We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits package here . Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process. All positions subject to close without notice.

Keywords: Intermountain Health, Grand Junction , Prospective Payment Coordinator, Healthcare , Grand Junction, Colorado