Coordinator-RAC TPE Position Available In Shelby, Tennessee

Coordinator-RAC TPE

Job ID:

30860

Job Category:

Finance and Accounting

Work Schedule:

Days

Department:

Revenue Cycle

Facility:

BMHCC System Services

Location:

Memphis, TN
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 billingpliance 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 excellentmunication 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:

ing 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 rmend such to manager.
ing

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