BILLING LIAISON

POSITION SUMMARY:

This position serves as a liaison between revenue cycle business offices, clients and third party billing vendors. . Individual should have strong working knowledge of compliance and regulatory policies that affect proper adjudication of claims. Must be able to communicate and maintain professionalism with clients, patients and all vendors.

POSITION EDUCATION/ QUALIFICATIONS­:

• Associate Degree or higher preferred
• 2 years of hospital or medical office billing/collections experience required
• Comprehensive knowledge of healthcare reimbursement, Medicare, Medicaid and commercial insurance claims processing methodology.
• Excellent written and verbal communication skills are required
• Ability to communicate clearly and concisely with all levels of management

JOB KNOWLEDGE/EXPERIENCE­:

• Must have professional and courteous demeanor
• Requires reasoning ability, analytical skills and good independent judgment.
• Strong time management, organization skills and attention to detail is essential
• Must have working knowledge specific to Medicare, Medicaid, managed care, and commercial insurances rules and regulations as they pertain to billing and appeals processing.
• Proficient in Microsoft office Products: Outlook, Word and Excel

POSITION RESPONSIBILITES:

• Ensures billing compliance by performing monthly financial and operational audits of various reports and trends these for productivity review of billing representatives, AR Management, reimbursement trends by payer and financial class.
• Communicates with clients to resolve missing or incorrect data entry of patient demographic information or insurance information
• Enters necessary data entry of Advanced Beneficiary Notices (ABN’s) signed by patients into the billing system
• Audits Advanced Beneficiary Notices (ABN’s) received for accuracy and reports deficiencies to  appropriate lab operations department manager
• Reviews payer remittance codes received after payment where a signed ABN has been identified for proper guarantor billing of non-covered lab services.
• Manages all returned patient statements and works to obtain correct mailing address utilizing all available resources including but not limited to payer websites, phone calls to patient or provider offices.
• Provides and coordinates with sales team deficiencies with client compliance of billing in regards to DX related non covered procedures and denials to identify trends where education to provider office could be provided
• Assists analysts in all special projects as needed
• Cross trains with billing and collection representatives to ensure and maintain adequate productivity to meet financial goals.
• Other duties as assigned.