RAC Coordinator - Payment Review Specialist (closed)
Award-winning St. Luke's Episcopal Hospital, located in the heart of the Texas Medical Center and named one of America's Best Hospitals by U.S.News & World Report is seeking a Payment Review Specialist with a strong background in RAC coordinating to join our Corporate Compliance team.
The Payment Review Specialist will facilitate the post-payment review processes beginning with the initial medical record request for review to final resolution of the account audit.
Payment reviews may include those conducted by the Recovery Audit Contractors (RAC); the Zone Program Integrity Contractors (ZPIC), the Medicaid Integrity Program (MIP) and other governmental reviews as necessary.
Duties will include the monitoring of each requested account beginning with the initial medical record request to final resolution of the claim.
The incumbent will also identify and advocate practices and processes, where necessary, to improve the efficiency and effectiveness of the handling of post-payment reviews.
- Four Year Degree required from an accredited university.
- 3-5 years of relevant experience within a hospital setting. BSN degree a major plus.
Medicare auditing, healthcare systems (comparable to InterQual, Milliman) will be given strong consideration.