Coordinator-RAC TPE Position Available In Shelby, Tennessee

Overview Coordinator-RAC TPE Job Code:

21540

FLSA Status Job Family:

FINANCE Job Summary Medicare / Medicaid Appeals Registered Nurse reviews and evaluates medical documentation to support billing compliance and external regulatory requirements. Job Responsibilities + Abstracts pertinent information from the medical record to create appeals for cases denied by governmental payors. + Educates department staff to issues related to the reimbursement process, as well as other concerns that result from monitoring activities. + Responsible for resolving issues as they occur. + Other duties as assigned.

Specifications Experience Description Minimum Required:

Required 2 years of healthcare care experience as

RN Preferred/Desired:

PREFERRED 5

years of healthcare care experience and 3 years in Medicare billing environment. Previous audit experience, knowledge of InterQual and Medicare Billing practices.

Education Description Minimum Required:

Diploma RN or RN AD Preferred/Desired:

BSN or RN with BS/BA in

Business Administration or Management Training Description Minimum Required:

Successful demonstration and detailed understanding of Hospital Revenue Cycle, CPT codes, HCPC codes, modifiers, and the Medicare/Medicaid Appeals Process. Familiarity of billing regulations including federal and guidelines. Must have excellent communication skills and proven ability to present.

Preferred/Desired Special Skills Description Minimum Required:

Strong knowledge of state and federal healthcare laws and regulations.

• Understanding of CMS coverage and payment methodologies

Preferred/Desired Licensure Description Minimum Required:

RN Preferred/Desired:

Reporting Relationships Does this position formally supervise employees? If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager.

Reporting Relationships:

No Work Environment Functional Demands Label Short Description Full Description Sedentary Very light energy level Lift 10lbs. box overhead. Lift and carry 15lbs. Push/pull 20lbs. cart Light Moderate energy level Lift and carry 25-35lbs. Push/pull 50-100lbs. (ie. empty bed, stretcher) Medium High energy level Lift and carry 40-50lbs. Push/pull +

• 150-200lbs.

(Patient on bed, stretcher) Lateral transfer 150-200lbs. (ie. Patient) Heavy Very high energy level Lift over 50lbs. Carry 80lbs. a distance of 30 feet. Push/pull > 200lbs. (ie. Patient on bed, stretcher). Lateral transfer or max assist sit to stand transfer.

Functional Demands Rating:

Sedentary Physical Activity Requirements

• Sitting:

  Continuous Physical Activity Requirements

• Standing:

  Frequent Physical Activity Requirements

• Walking:

  Occasional Physical Activity Requirements

• Climbing (e.g., stairs or ladders): Occasional Physical Activity Requirements
• Carry objects: Occasional Physical Activity Requirements

• Push/Pull:

  Occasional Physical Activity Requirements

• Twisting:

  Occasional Physical Activity Requirements

• Bending:

  Occasional Physical Activity Requirements

• Reaching Forward:

  Occasional Physical Activity Requirements

• Reaching Overhead:

  Not Anticipated Physical Activity Requirements

• Squat/Kneel/Crawl:

  Not Anticipated Physical Activity Requirements

• Wrist position deviation: Continuous Physical Activity Requirements
• Pinching/fine motor activities: Occasional Physical Activity Requirements
• Keyboard use/repetitive motion: Continuous Physical Activity Requirements
• Taste or smell: Not Anticipated Physical Activity Requirements
• Talk or hear:

Continuous Sensory Requirements Color Discrimination:

Yes Near Vision:

Accurate Far Vision:

Accurate Depth Perception:

Accurate Hearing:

Accurate Environmental Requirements

• Blood-Borne Pathogens:

  Not Anticipated Environmental Requirements

• Chemical:

  Not Anticipated Environmental Requirements

• Airborne Communicable Diseases:

  Not Anticipated Environmental Requirements

• Extreme Temperatures:

  Not Anticipated Environmental Requirements

• Radiation:

  Not Anticipated Environmental Requirements

• Uneven Surfaces or Elevations:

  Not Anticipated Environmental Requirements

• Extreme Noise Levels:

  Not Anticipated Environmental Requirements

• Dust/Particular Matter:

  Not Anticipated Environmental Requirements

• Other

REQNUMBER

30860