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:

  1. Develops and assembles the personnel for the APC team;
  2. Researches and analyzes information concerning the APC PPS;
  3. Routinely monitors the Federal Register and other sources for information pertaining to APCs and outpatient payment reform;
  4. Monitors the Internet and applicable listservs for information and developments concerning APCs and other APC-Type Payment Systems;
  5. Develops strategies for developing and implementing changes to prepare the hospital for APCs;
  6. Directs and coordinates the activities of the APC team;
  7. Write reports and keeps upper management informed concerning progress and/or problems relative to preparing for APCs;
  8. Works with virtually all departments and service areas relative to changes necessary for implementation of APCs;
  9. Assists financial department personnel in developing financial impact scenarios and impact analysis projections;
  10. Works with health information management personnel in developing the skills and resource base for coding for APCs;
  11. Works with Information Technology and Management Information System relative to implementation and use of APCs grouping/pricing software.
  12. Works with IT and MIS for development of longitudinal outpatient data base development using APCs;
  13. Works with the finance department for use of APC for cost management;
  14. Works with the Charge Master Coordinator to review and implement Charge Master changes for APC implementation;
  15. Works with patient accounting relative to implementation of billing changes;
  16. Works with the training department to develop an APC curriculum involving both internal and external training;
  17. Works with the cost reporting function to assure that the cost reports are being developed appropriately relative to APCs;
  18. As appropriate works with external consultants relative to special needs and/or projects for APC implementation;
  19. Maintains contact with and gathers information from the local Fiscal Intermediary, regional and national HCFA offices;
  20. Works with other professionals in other hospitals and/or integrated delivery systems that are preparing for APC implementation;


Knowledge, Abilities and Personal Characteristics:

  1. Extensive knowledge of various hospital reimbursement systems;
  2. Extensive knowledge of various coding systems including CPT and ICD-9-CM;
  3. Knowledge of the content, structure and maintenance of the Charge Master;
  4. Conceptual knowledge of the cost reporting process;
  5. 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;
  6. A basic knowledge of statistical functions and analytical techniques;
  7. Knowledge of compliance concerns relative to coding, billing, reimbursement and documentation;
  8. Knowledge of team development and dynamics;
  9. Ability to communicate well with personnel of varied technical backgrounds;
  10. Ability to present and train to groups of people;
  11. Ability to perform financial analyses;
  12. Ability to write and prepare technical reports;
  13. Ability to organize and design complex projects;
  14. High acuity to solve problems and address complex situations;
  15. Ability to address multiple and disparate tasks at the same time;
  16. 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.


Subordinate Personnel:

Administrative Assistant as appropriate.

Reports To:

Vice-President of Finance or CFO as appropriate.

Notes: This is a highly responsible technical position at the professional level.