DRG PACT Specialist at Community Health Systems (Nashville, TN)

| Nashville, TN
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The Diagnosis Related Group (DRG) Post Acute Care Transfer (PACT) Specialist position is primarily responsible for the collection, analysis, and completion of post-acute care transfers.

Essential Duties and Responsibilities:

  1. Responsible for compiling data for all CHS hospitals for the DRG Transfer Project for Medicare and Medicare HMO payors.
  2. Research and validate post-acute care transfers in multiple systems.
  3. Complete work orders of PACT and Third Party Vendor requests and track to completion.
  4. Research expected gains of Medicare and Medicare HMO accounts.
  5. Resolve any recoups of payments.
  6. Assist Corporate IT in developing software for the DRG Transfer project.
  7. Assist leadership with any other projects/audits as assigned and needed.
  8. Other duties as assigned.

Required Education: High School Diploma
Preferred Education: College Degree Preferred

Required Experience: Medicare and Commercial Insurance Reimbursement Knowledge
Preferred Experience: Minimum of 3 years working with Medicare and Medicare HMO claims preferred

Computer Skills Required: Proficient computer skills including all Microsoft Office functions. Must be very proficient in Microsoft Excel. Must possess very strong organizational and written/verbal communication skills. Knowledge of CMS, DDE, My Ability is a plus.

Physical Demands:
In order to successfully perform this job, with or without a reasonable accommodation, the following are outlined below:

  1. The Employee is required to read, review, prepare and analyze written data and figures, using a PC or similar, and should possess visual acuity.
  2. The Employee may be required to occasionally climb, push, stand, walk, reach, grasp, kneel, stoop, and/or perform repetitive motions.
  3. The Employee is not substantially exposed to adverse environmental conditions and; therefore, job functions are typically performed under conditions such as those found within general office or administrative work.
More Information on Community Health Systems
Community Health Systems operates in the Healthtech industry. The company is located in Franklin, TN. Community Health Systems was founded in 1985. It has 10001 total employees. It offers perks and benefits such as Flexible Spending Account (FSA), Disability Insurance, Dental Benefits, Vision Benefits, Health Insurance Benefits and Life Insurance. To see all 29 open jobs at Community Health Systems, click here.
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