Northwestern Medicine Central DuPage Hospital ยท 3 months ago
Patient Accounting RAC Analyst
Warrenville, IL
Full-time
Onsite
Mid, Senior Level
4+ years expNorthwestern Medicine Central DuPage Hospital is dedicated to delivering world-class care and innovation in medicine. They are seeking a Patient Accounting RAC Analyst to support activities related to the Medicare and Medicaid Recovery Audit Contractor programs, focusing on generating financial information for RAC claims and ensuring compliance with relevant standards.
Hospital & Health Care
Responsibilities
Monitor RAC program updates, as they relate to Patient Accounting and Patient Financial Service functions (i.e., Admitting & Registration and Patient Accounting). In conjunction with the Office of Corporate Compliance & Integrity and other areas, assist in the coordination of and perform various RAC related activities that are the responsibility of the PA department to ensure RAC documentation requests and deadlines are met
Monitors RAC related publications and resources to assist Patient Accounting management with understanding RAC related issues, as it relates to PA functions
Monitors and communicates potential RAC issues impacting Patient Accounting and compiles action/activity reports in support of corrective action/process improvement
Generates financial and other relevant information for RAC claims under review and researches and facilitates data gathering for Manager of Patient Accounting, Director of Patient Accounting and/or the Office of Corporate Compliance & Integrity providing data and/or various reports
Inputs RAC notation, DRG, claim, and reimbursement information related to RAC claims under review into appropriate systems (i.e., Primes, RACTracker, etc.) Collects, organizes, and interprets RAC data for identification and prioritization of areas of risk
Works with Office of Corporate Compliance & Integrity, Billing and other hospital areas to implement operational changes to ensure NM compliance with RAC requirements as they relate to PA functions
Works with the NM Academy and PFS Management to ensure timely, accurate, and regular Compliance Education and Training programs within PFS
Adjusts claim information in applicable systems to appropriately reflect accurate DRG, level of care, etc. for RAC claims under review
Assess/evaluate new RAC information and help determine required systems or operational actions
Document completely, issues and resolutions, on a case by case basis, providing a comprehensive audit trail
Consistently practice 'Patients First' philosophy and adhere to high standard of customer service consistently for internal and external customers
Evaluate procedures and suggest improvements and changes to enhance customer service and operational efficiency
Performs other related duties as assigned by manager
Qualification
Required
Bachelors Degree or four additional years of relevant experience
4-6 years of hospital healthcare experience equivalent with specific government programs focus
Knowledge of Recovery Audit Contractor Program
Knowledge of ICD 9/10, CPT, HCPCS & MS-DRG coding, healthcare billing, medical records
Ability to review/analyze billing documentation including UB 04 bill form, CMS 1500 form, EOBs & remittance advices
Demonstrated ability to work with various levels within the organization regarding confidential information and maintain sensitive data
Expert user experience with MS Excel
Ability to run system queries & reports
Strong interpersonal skills, demonstrate ability to listen effectively
Excellent written and oral communication skills
Preferred
MS Word & PowerPoint ability
Coding credential (CCS, CPC-H, RHIT, RHIA)
Project Management
Benefits
$10,000 Tuition Reimbursement per year ($5,700 part-time)
$10,000 Student Loan Repayment ($5,000 part-time)
$1,000 Professional Development per year ($500 part-time)
$250 Wellbeing Fund per year ($125 for part-time)
Matching 401(k)
Excellent medical, dental and vision coverage
Life insurance
Annual Employee Salary Increase and Incentive Bonus
Paid time off and Holiday pay
Company
Northwestern Medicine Central DuPage Hospital
Central DuPage Hospital is part of Northwestern Medicine.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Claudia Mahoney
Associate Chief Nursing Officer
Jessica Arendarczyk
Project Partner
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