RAC Coordinator

Lake Charles Memorial Health System; Lake Charles (LA); On-site; USD 65,000 - 80,000; Full time

Job summary

Lake Charles Memorial Health System seeks a Revenue Management RAC Coordinator to monitor RAC activity, ensure timely responses to correspondence, and keep codes within guidelines. This role supports risk analysis and assists with appeals, helping the hospital stay compliant with federal and state regulations.

You will work with physicians and administrative staff to identify correct revenue codes and HCPCS codes, review inpatient and outpatient records, and document RAC results with

Qualifications

• Bachelor's degree in Business/Finance or Accounting required.
• Experience with PC, word processing, spreadsheet, graphics, and database software.
• Strong quantitative, analytical, and organizational skills.
• Ability to communicate orally and in writing.
• Team oriented with strong interpersonal skills.

Responsibilities

• Proficient in payment review systems, hospital information systems, and coding methodologies.
• Understand CMS correspondence as it relates to RAC topics.
• Interpret medical records, hospital bills, and the charge master.
• Understand RAC requests.
• Collaborate with physicians, administrative staff, and department managers.
• Identify accurate revenue codes and HCPCS Level II codes.
• Identify clerical errors and inaccuracies in RAC audits.
• Perform inpatient and outpatient reviews for coding/charging accuracy.
• Document RAC activity results and provide recommendations to departments.

Skills

CMS knowledge

Communication skills

Team collaboration

Education

Bachelor's degree in Business/Finance or Accounting

Tools

Hospital information systems

Coding methodologies

Charge master understanding

Job description

Revenue Management RAC Coordinator

Description Of Position

The RAC Coordinator monitors and maintains the hospital's RAC activity to ensure letters are received and responded to timely, codes are within applicable coding guidelines, provides risk analysis, and assists with appeals for resolution. The role keeps the hospital compliant with federal and state regulations.

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 requests.
• 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 code 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.
• Document results of all RAC activity and provide 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 database 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.