Accounting, Analysis Skills, Centers for Medicare and Medicaid Services (CMS), Chargemaster, Content Management Systems (CMS), Database Management Software/Systems (DBMS), Documentation, Federal Laws and Regulations, Finance, Graphics, Healthcare Common Procedure Coding System (HCPCS), Hospital, Information Technology & Information Systems, Interpersonal Skills, Medical Billing, Medical Coding, Medical Diagnosis, Medical Records, Nursing Credentials, Organizational Culture, Organizational Skills, Outpatient Care, Patient Care, Presentation/Verbal Skills, Quantitative Analysis, Regulations, Revenue Management, Risk Analysis, Spreadsheets, State Laws and Regulations, Team Player, Time Management, Training/Teaching, Word Processing
Revenue Management RAC Coordinator
DESCRIPTION OF POSITION:
- The RAC Coordinator monitors and maintains the hospital's RAC activity to ensure that the letters are received and responded to timely, codes are within applicable coding guidelines, provides risk analysis, appeals or assists with appeals for resolution timely, and provides feedback and/or training to reduce future exposures. The RAC Coordinator is responsible for assisting with keeping the hospital compliant with federal and state regulations
SUPERVISION: Reports directly to the Director of Revenue Management
RESPONSIBILITIES AND DUTIES:
- Proficient in payment review systems, hospital information systems and coding methodologies.
- Ability to understand CMS (formerly HCFA) correspondence as it relates to RAC topics.
- Ability to understand and interpret medical records, hospital bills, and the charge master.
- Ability to understand RAC request.
- Ability to work with physicians, administrative staff, and department managers effectively.
- Ability to identify accurate revenue codes, and HCPCS Level II codes for service/items.
- Ability to identify clerical errors, mistakes in interpretation, imprecise records, and inaccurate service codes assignment during the RAC audits.
- Perform inpatient and outpatient reviews for appropriateness of coding and charging, including Business Office activities, systems functions, and charging methodologies to prevent any future RAC exposure.
- Documenting results of all RAC activity and providing recommendations to all departments involved to keep LCMH compliant with regulations.
The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.
EDUCATION AND WORK EXPERIENCE
- 4 year degree in Business/Finance or Accounting is required. A degree or certificate in nursing or in an ancillary therapeutic or diagnostic patient care field may be substituted. B.A. degree or equivalent work experience in similar fields considered.
- Experience with PC, word processing, spreadsheet, graphics, and data base software applications are desired.
- Previous patient care experience, preferred.
- Strong quantitative, analytical, and organizational skills.
- Ability to communicate orally and in written form.
- Must be team oriented with strong interpersonal skills.
Physical Demands/Work Environment
- Requires prolonged periods of sitting with a light amount of lifting of physical records/documents weighing up to 10 pounds.
- Almost 100% of time spent inside the building.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
“Experience Memorial” is more than a slogan, it’s the care we provide our patients and it’s the commitment to our community and our team members. As a nationally certified Great Place to Work, at Lake Charles Memorial Health System you will have the opportunity to be a part of an organizational culture that supports not only exceptional patient care but also the well-being and professional growth of our employees. Join us and be a part of a team where your contributions are valued, your growth is nurtured, and your success is celebrated.
Working at Lake Charles Memorial Health System | Great Place To Work®
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Lake Charles Memorial Health System