Overview:

We are seeking Revenue Cycle Liaison to serve as the primary intermediary between a company’s billing department, clients, and other stakeholders such as an outsourced billing entity. They streamline the revenue cycle by resolving billing disputes, ensuring accurate invoicing, correcting discrepancies, and answering patient or client inquiries. The Revenue Cycle Liaison also manages the Sliding Fee program and performs insurance enrollment for CHC providers.

Primary Responsibilities and Duties

1. Billing Duties

a. Intermediary Communication: Act as the bridge between CHC sites and the Central Billing Office (CBO) to align revenue goals.

b. Investigate and resolve billing discrepancies, undercharges, or overcharges with patients, clients, and insurance companies.

c. Review end-of-day charge reports, monitor for errors, and generate billing reports.

d. Educate internal staff on proper revenue cycle workflows and ensure they understand up-to-date payer or Medicare billing

e. Generates quarterly credit balance reports for Medicare and Medicaid.

f. Update patient accounts with correct insurance

g. Maintains organized records of EOB’s, correspondence with insurance companies, Medicare, and Medicaid remittances, etc.

h. Communicates in conjunction with the CBO with insurance companies, clearinghouse, and software vendors and disseminates information regarding contract/fee schedule changes, regulation changes, billing, collections, A/R, reimbursement, etc. to leadership and other team members as appropriate.

2. Provider Insurance Enrollment (Credentialing)

a. Completes enrollment process for providers to participate with 3rd party insurance companies that CHC contracts with.

b. Ensures timely and accurate enrollment with NC Tracks for all CHC providers

c. Ensures timely and accurate enrollment with PECOS for all CHC providers

d. Manages CAQH profiles for all CHC providers

e. Ensures timely communication and response to all requests for information from payors

3. Accounts Receivables

a. Appropriately responds to patient inquiries and requests pertaining to billing.

b. Discuss bad debts with patients and develop a payment plan.

c. Prepares file for patient statements and submits to Clearinghouse

d. Posts payments, as needed

e. Works aged accounts to determine cause; takes appropriate action

f. Performs bad debt write off, at the direction of department leadership and according to company policies.

g. Research refunds and process for payment.

4. Administrative Duties

a. Prepares daily bank deposit.

b. Prepares outgoing mail and distributes incoming mail.

c. Runs daily errands such as bank, Post Office, etc.

d. Generates reports (month end, fiscal year end, UDS, and other reports as needed).

5. Sliding Fee

a. Explains Sliding Fee program to patients and assists patients with enrollment process for Sliding Fee program.

b. Ensures appropriate discount category is correctly entered in the patient’s medical record, after approval of S/F application.

c. Verifies sliding fee adjustments are correctly applied to patient accounts

d. Corresponds with patients as needed, prepares and sends letters for S/F renewals.

e. Maintains records for Sliding Fee program.

Primary Attributes

Professional & Technical Knowledge:

· Possesses work-related skills at a higher level than completion of high school, including formal written and verbal communications skills, computational and computer skills, mathematical, technical or [industry] related knowledge frequently acquired through completion of a trade school, para-professional, or certificate type program.

· Is expected to learn and maintain higher level skills of the trade/profession, in addition to the basic training of the trade/profession.

Continuing Education:

· Maintains current knowledge of coding, insurance regulations, insurance claims submission specific to carriers, Medicare, and Medicaid regulations applicable to billing/claims processes, and requirements of Managed Care insurance companies.

Licenses & Certifications:

· Certified Professional Biller (CPB) credential from the American Academy of Professional Coders (AAPC), Certified Billing and Coding Specialist (CBCS) credential from the National Healthcareer Association (NHA), or equivalent nationally recognized healthcare billing certification is preferred, but not required.[EB1]

Technical Skills:

· Uses general computer applications to perform routine tasks, including email, internet browsing, data entry, and accessing shared files and web-based systems.

· Demonstrates necessary proficiency with all electronic clinical systems, including EHR and scheduling systems, in use at CHC.

General Development:

· Functions effectively in response to workflow or ongoing direction by supervisors.

· Determines effective responses to situations encountered within established precedents.

· Able to effectively explain complex or technical information to others.

· Exercises tact and diplomacy in the resolution of mild conflicts or disagreements.

Work Environment:

· Work is performed in a typical office environment.

Physical Requirements

· Performance of essential duties requires extended periods of sitting and using hands to write, operate a computer, and type. Frequently must reach with hands and arms. Vision requirements are close vision and the ability to adjust focus. Performance of essential duties requires hearing acuity and the ability to speak clearly.

The selected candidate must meet Compassion Health Care’s employment eligibility requirements, including but not limited to successfully completing pre-employment drug testing and criminal background screening.

Job Type: Full-time

Pay: From $49,200.00 per year

Benefits:

• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Tuition reimbursement
• Vision insurance

Experience:

• EHR systems: 1 year (Preferred)
• Microsoft Excel: 3 years (Preferred)

Work Location: Hybrid remote in Yanceyville, NC 27379