This position has access to and knowledge of extremely sensitive, private and confidential materials. Ability to maintain the highest standard is required with zero tolerance.
All the primary duties within this document will be performed according to established policies, procedures and guidelines within the department and the Medical Center.
The RAC Account Technician will perform a variety of work activities associated with the Recovery Audit Contractor. The RAC Account Technician is responsible for monitoring and reconciling patient account specific RAC data, review of payments, recoupments, and appeals movement. The RAC Accounts Technician is responsible for tracking and reporting data. Ensures efficient delivery of timely, organized department services, ability to organize work and adaptability to changing conditions and job details. Communicates effectively using discretion and independent judgment with internal and external customers. Performs other duties as assigned.
PRIMARY JOB DUTIES:
1. Enters information for medical records requests into racking software. Enters and maintains the ongoing status of each stage to include determinations, appeals, and financial status into tracking software.
2. Prepare medical records for delivery to all Recovery Auditors, following policy and procedure. To include quality reviews and documents to ensure all documents are accounted for and sent to the Recovery Auditor.
3. Responsible for communicating and notifying Recovery Audit appropriate team members of the requests, denials, approaching deadlines, financial statuses, and milestone dates/ deadlines. Track handoffs between departments/ responsible staff/ management to ensure timeliness.
4. Enter, monitor, and manage all financial data into working file. Maintain designated databases and spreadsheets.
5. Consistently and timely check Recovery audit, Payor (Palmetto GBA), and other resourceful websites for updated information and share with Recovery Audit Manager and team
6. Monitor EOB postings and FISS related to RAC accounts. Monitor and reconcile financial data to include RA, N432/ N469, UB, and other triggers.
7. Report all transactions and financial statuses to manager and Steering Committee. Responsible to ensure all requests are timely and deadlines are met.
8. Performs a variety of duties and responsibilities within RAC to include, but not limited to, billing, reconciliation, and accurate payment posting to RAC patient accounts.
9. Function independently in a high volume, multi-task setting. Must function in a highly computerized/technical environment, maintaining competency and knowledge of multiple internal/external software systems.
10. Maintain courteous and cooperative working relationships with peers, customers and other medical center team members.
11. Organizes and performs work effectively and efficiently.
12. Record minutes for all meetings to include but not limited to: RAC Steering Committee, RAC Operations, HIM Departmental, and RACMonitor
13. Effectively demonstrates the mission, vision, and values of NHRMC on a daily basis.
14. Performs other related duties as required.
ESSENTIAL JOB SPECIFICATIONS:
1. Education: High school diploma or equivalent required.
2. Licensure / Certifications: Certified Patient Account Technician (CPAT) preferred.
3. Experience: Two – three years of patient accounting experience. Two - three years HIM Analysis experience. Experience with denials and reimbursement and CMS guidelines preferred.