Position Overview

The RAC Coordinator monitors and maintains hospital RAC activity to ensure letters are received and responded to on time, coding is compliant with applicable guidelines, and appeals are prepared or supported in a timely manner. This role provides risk analysis, feedback, and training to reduce future exposure and helps keep the hospital compliant with federal and state regulations.

Key Responsibilities

Monitor RAC activity and manage responses to RAC correspondence.
Review payment review systems, hospital information systems, and coding methodologies.
Interpret CMS correspondence related to RAC topics.
Review medical records, hospital bills, and chargemaster information.
Identify accurate revenue codes and HCPCS Level II codes for services and items.
Detect clerical errors, interpretation mistakes, imprecise records, and inaccurate code assignments during RAC audits.
Perform inpatient and outpatient reviews related to coding, charging, business office activities, systems functions, and charging methodologies.
Document RAC activity and provide recommendations to departments to maintain compliance.

Qualifications

4-year degree in Business, Finance, Accounting, or a related field required.

Nursing degree/certificate or an ancillary therapeutic or diagnostic patient care credential may substitute.

Equivalent work experience in a similar field may be considered.

Experience with PC applications, word processing, spreadsheets, graphics, and databases preferred.

Previous patient care experience preferred.

Strong quantitative, analytical, and organizational skills.

Strong oral and written communication skills.

Team-oriented with strong interpersonal skills.