IRF-PAI Certification Pathway
Progress from foundational coordinator skills to expert-level mastery and audit specialist certification
Level 1
IRF-PAI Coordinator
Foundation certification for basic coordinator competency
Level 1: Coordinator
Core Modules (10):
- IRF-PAI Overview
- Tier Coding Guide
- FIM Scoring Training
- Documentation Requirements
- Physician Query Guide
- Daily Workflow
- Accuracy Process
- Audit Prevention
- Case Studies
- Compliance Basics
Assessment:
50-question certification exam (80% passing)
Competency Validation:
6 full patient assessments (80% accuracy required)
Level 2: Advanced Specialist
Advanced Modules (4):
Requirements:
Complete all 4 modules with 85% or higher on each quiz
Skills Demonstrated:
- • Navigate ambiguous clinical scenarios
- • Identify complex comorbidity patterns
- • Conduct internal audit reviews
- • Write sophisticated physician queries
Level 3: Mastery & Audit Specialist
Expert Modules (5):
Requirements:
Complete all 5 modules with 90% or higher on each quiz
Expert Skills:
- • Conduct detailed facility audits
- • Defend charts during MAC audits
- • Navigate Medicare appeals process
- • Master regulatory compliance
What Each Certification Enables
Career progression and expanded responsibilities
Level 1: Coordinator
- ✓ Complete IRF-PAI assessments independently
- ✓ Code tier comorbidities accurately
- ✓ Score FIM items correctly
- ✓ Write basic physician queries
- ✓ Follow daily workflow procedures
- ✓ Maintain compliance with CMS guidelines
Level 2: Advanced Specialist
- ✓ Handle complex coding scenarios
- ✓ Mentor junior coordinators
- ✓ Conduct internal audit reviews
- ✓ Identify facility coding patterns
- ✓ Lead quality improvement initiatives
- ✓ Serve as facility coding resource
Level 3: Mastery & Audit Specialist
- ✓ Lead facility audit defense
- ✓ Respond to MAC audit requests
- ✓ Manage Medicare appeals process
- ✓ Train facility staff on compliance
- ✓ Develop facility coding policies
- ✓ Serve as expert consultant