RAC/PI Specialist |
| Location: | Lafayette, IN |
| Exempt/Non-Exempt: | Exempt |
| Benefits: | Benefit Eligible |
| Type: | Full-Time |
| Facility: | St. Elizabeth Regional Health |
| Description: | The RAC/Process Improvement Specialist (RAC/PI Specialist) is responsible for assisting the Revenue Management Divisions with the identification, development, implementation, revenue and outcome tracking of all Process Improvement initiatives. The incumbent is additionally responsible for coordination of the RAC process at all WIR facilities. |
| Duties: | ASSUMES RESPONSIBILITY FOR RECOVERY AUDIT CONTRACTOR RELATED FUNCTIONS Works closely with President’s office at each WIR facility to assure timely receipt of RAC requests Maintains the RAC database including entry of RAC requests into database and production of management reports Coordinates reply to all RAC requests; assures that timeframes are met Coordinates all aspects of the RAC Committee Provides management report and trending on RAC initiatives to the RAC Committee and Senior Management at each facility Assists with the appeals process as appropriate; assures appeal timeframes are met
ASSUMES RESPONSIBILITY FOR PROCESS IMPROVEMENT Works collaboratively with RMD divisions and hospital departments to identify process improvement opportunities, implement process improvement plans and enhance revenue collection through process improvement initiatives Monitors a variety of resources for potential PI opportunities including the Observation Log, CMS regulations, department databases and divisional input Provides data to divisions and hospital departments to assist in the determination of the need for PI initiatives Is knowledgeable and applies Six Sigma methodologies to process improvement
DEMONSTRATES INCREASED NET REVENUE, IN TOTAL AND BY FACILITY Works closely with RMD staff to identify and implement revenue opportunities and quantify potential impact Acts as a resource for hospital departments Prepares reports as required by management to document process improvement recommendations, implementation and progress Completes monthly tracking of revenue associated with completed PI projects
DEMONSTRATES ABILITY TO EFFECTIVELY MANAGE MULTIPLE PROJECTS WITH INNOVATION, CREATIVITY AND VISION Investigates and documents any potential for new program, product development or process improvement opportunity. Documents results of all special project work, and provides recommendations for revenue managing opportunities relating to special projects. Illustrates creative problem solving skills through PI initiatives. Illustrates proficiency in the use of all software applications required to perform job functions. |
| Qualifications: | Above average communication skills preferred. Strong, multi-faceted clinical background in acute hospital care. Computer proficiencies to enter, retrieve, assemble and organize data. Ability to integrate data from multiple sources. Skilled in effective group facilitation and presentation of data to groups. Skilled in mathematical concepts and basic statistical methodologies/applications. Associate or Bachelor degree required. Minimum of 3 years experience in Healthcare Finance, Billing, and/or Internal Audit functions required. Previous clinical experience strongly preferred. Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Coding Specialist (CCS) or Certified Procedural Coder, Hospital (CPC-H) required. Clinical license also preferred (e.g., RN, MLT). |
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