Inpatient Rehab Documentation Coordinator

About the role

The Clinical Documentation Improvement (CDI) Specialist for inpatient rehabilitation ensures that medical records accurately reflect patient complexity and resource use, supporting compliance and reimbursement. Reporting to the Rehab Quality/PPS Manager, the role also serves as the RN representative on weekly interdisciplinary team conferences, using clinical interviews and record reviews to align patient status with the IRF‑PAI.

Key responsibilities

• Ensure medical records accurately capture patient complexity, resources, and functional status to support compliance and reimbursement.
• Act as the RN representative at weekly interdisciplinary team meetings, conducting clinical interviews and reviewing records to align patient status with the IRF‑PAI.

Required profile

• Active Registered Nurse (RN) license.
• Minimum 3 years of clinical experience in an Inpatient Rehabilitation Facility or acute‑care setting.
• Proficiency in ICD‑10‑CM coding and Section GG functional scoring.
• Strong communication skills to lead discussions with physicians, therapists, and case managers.
• High attention to detail with ability to identify clinical inconsistencies across disciplines.

Required skills

• ICD‑10‑CM coding
• Section GG functional scoring