RAC Coordinator (Full Time)

Lake Charles Memorial Hospital; Lake Charles (LA); On-site; USD 50,000 - 70,000; Full time

Job summary

Lake Charles Memorial Hospital is seeking a RAC Coordinator. This role involves monitoring the hospital's RAC activity, ensuring timely responses and compliance with regulations. You'll provide risk analysis, assist with appeals, and train staff to minimize future exposures.

A 4-year degree in Business/Finance or Accounting is required, along with strong analytical skills. The role is mainly office-based with light physical demands.

Qualifications

• 4 year degree or equivalent work experience in similar fields.
• Experience with patient care preferred.
• Ability to communicate orally and in written form.

Responsibilities

• Monitor and maintain the hospital's RAC activity.
• Provide risk analysis and assist with appeals for resolution.
• Document results of RAC activity and make recommendations.

Skills

Proficient in payment review systems

Understanding CMS correspondence

Medical records interpretation

Identifying revenue codes

Analytical and organizational skills

Strong interpersonal skills

Education

4 year degree in Business/Finance or Accounting

Degree or certificate in nursing

Tools

PC

Word processing applications

Spreadsheet software

Job description

Overview

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.