APC Coordinator Job Description
Apex Medical Center
Job Title: APC Coordinator
Job Description: Under limited supervisions directs and coordinates the activities of a highly specialized and technical team with the purpose of examining various departments and functions within the hospital and making the necessary changes and/or improvements to prepare the hospital for implementation of hospital prospective payment through Ambulatory Payment Categories (APCs), other associated APG-Type Payment Systems and/or other PPS payment systems.
Typical Job Duties:
- Develops and assembles the personnel for the APC team;
- Researches and analyzes information concerning the APC PPS;
- Routinely monitors the Federal Register and other sources for information pertaining to APCs and outpatient payment reform;
- Monitors the Internet and applicable listservs for information and developments concerning APCs and other APC-Type Payment Systems;
- Develops strategies for developing and implementing changes to prepare the hospital for APCs;
- Directs and coordinates the activities of the APC team;
- Write reports and keeps upper management informed concerning progress and/or problems relative to preparing for APCs;
- Works with virtually all departments and service areas relative to changes necessary for implementation of APCs;
- Assists financial department personnel in developing financial impact scenarios and impact analysis projections;
- Works with health information management personnel in developing the skills and resource base for coding for APCs;
- Works with Information Technology and Management Information System relative to implementation and use of APCs grouping/pricing software.
- Works with IT and MIS for development of longitudinal outpatient data base development using APCs;
- Works with the finance department for use of APC for cost management;
- Works with the Charge Master Coordinator to review and implement Charge Master changes for APC implementation;
- Works with patient accounting relative to implementation of billing changes;
- Works with the training department to develop an APC curriculum involving both internal and external training;
- Works with the cost reporting function to assure that the cost reports are being developed appropriately relative to APCs;
- As appropriate works with external consultants relative to special needs and/or projects for APC implementation;
- Maintains contact with and gathers information from the local Fiscal Intermediary, regional and national HCFA offices;
- Works with other professionals in other hospitals and/or integrated delivery systems that are preparing for APC implementation;
Knowledge, Abilities and Personal Characteristics:
- Extensive knowledge of various hospital reimbursement systems;
- Extensive knowledge of various coding systems including CPT and ICD-9-CM;
- Knowledge of the content, structure and maintenance of the Charge Master;
- Conceptual knowledge of the cost reporting process;
- Knowledge of computer systems and their capabilities relative to coding, billing and reimbursement monitoring including use of grouper software and the development of longitudinal data bases;
- A basic knowledge of statistical functions and analytical techniques;
- Knowledge of compliance concerns relative to coding, billing, reimbursement and documentation;
- Knowledge of team development and dynamics;
- Ability to communicate well with personnel of varied technical backgrounds;
- Ability to present and train to groups of people;
- Ability to perform financial analyses;
- Ability to write and prepare technical reports;
- Ability to organize and design complex projects;
- High acuity to solve problems and address complex situations;
- Ability to address multiple and disparate tasks at the same time;
- Ability to be a team leader.
Experience and Education:
Five to ten years of progressive experience in various hospital functions including coding, reimbursement, finance, billing and/or various service areas.
Education at the bachelors level is mandatory and advanced degrees are desirable.
Additional applicable experience may be substituted for educational requirements.
Licenses, Certification and/or Special Training:
Certification for CPT and ICD-9-CM coding is desirable.
Certification in hospital financial areas is desirable.
Administrative Assistant as appropriate.
Vice-President of Finance or CFO as appropriate.
Notes: This is a highly responsible technical position at the professional level.