DRG PACT Specialist
Summary:
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:
- Responsible for compiling data for all CHS hospitals for the DRG Transfer Project for Medicare and Medicare HMO payors.
- Research and validate post-acute care transfers in multiple systems.
- Complete work orders of PACT and Third Party Vendor requests and track to completion.
- Research expected gains of Medicare and Medicare HMO accounts.
- Resolve any recoups of payments.
- Assist Corporate IT in developing software for the DRG Transfer project.
- Assist leadership with any other projects/audits as assigned and needed.
- Other duties as assigned.
Qualifications:
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:
- The Employee is required to read, review, prepare and analyze written data and figures, using a PC or similar, and should possess visual acuity.
- The Employee may be required to occasionally climb, push, stand, walk, reach, grasp, kneel, stoop, and/or perform repetitive motions.
- 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.