Revenue Integrity Clin Liaison

2 months ago

Orlando, United States Orlando Health Full time

Position Summary:

The Revenue Integrity Clinical Liaison has clear understanding of the hospital revenue cycle. Is responsible for ensuring service lines, within designated areas of responsibility, are capturing all appropriate revenue through the ongoing monitoring of regulatory and
compliance rules as set by Medicare and other Payers. Identifies revenue opportunities and formulates plan that will ensure process improvement is understood and documented throughout the revenue cycle with the expected outcome being increased revenue
capture and decreased denials. Communicates and interfaces professionally with all team members in the Revenue Integrity Department so that overlap of processes is minimized and communication between parties is enhanced thus improving overall work flow.

Responsibilities:

Essential Functions

  • Ensures goals are met on time, within budget and per regulatory guidelines through approved methods and standards.
  • Assists other areas in the Revenue Cycle to complete projects.
  • Establishes rapport and maintains collaborative relationship with peers.
  • Builds relationships with Administration, CFOs, Managers and contacts at all sites for all areas of responsibility.
  • Works collaboratively with IS, Nursing and Revenue Management departments in the process improvement and implementation of charge capture opportunities.
  • Develops relationships with various committees and groups to ensure continuity in processes that increase revenue capture.
  • Represents the Revenue Integrity department professionally and positively in both formal and informal settings by maintaining a high level of professional demeanor and dress at all times.
  • Maintains an ongoing database of contacts from each site for each department to include charge entry system being used.
  • Assists all departments in understanding their responsibility to perform daily charge capture and reconciliation processes for their departments.
  • Maintains a downtime procedure that can be executed quickly and will assist departments to understand their responsibility during downtime of their charge capture system.
  • Reports charge capture successes as they occur in charge entering areas.
  • Maintains policies, procedures and manuals as assigned.
  • Prepares and distributes executive summaries as they relate to process improvement in revenue capture.
  • Maintains a rapport and frequent visibility with all contacts that will foster a trusting relationship, encourage discovery of revenue capture opportunities and provide for a forum to identify interruption in revenue streams.
  • Understands and can apply pricing methodologies to charges.
  • Reviews regulatory alerts and updates as they pertain to areas of responsibility, makes changes in the Chargemaster regulatory system applications and notifies contacts as appropriate.
  • Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
  • Maintains compliance with all Orlando Health policies and procedures.

Other Related Functions
Acts as resource to assist in education and understanding of regulatory rules, charge capture and reconciliation. Performs other duties as assigned.

Qualifications:

Education/Training
Bachelors degree in business administration, finance, computer science or healthcare related field. Associate degree and two (2) years of directly related work experience may substitute for the Bachelors degree (in addition to the requirements listed in the
Experience section).

Experience
Four (4) years of clinical or hospital experience or 1year management experience within a hospital. Understanding of the Revenue Cycle in a hospital. Knowledge of Medicare, Medicaid, Medicare OPPS reimbursement and other third party billing rules and coverage.
Regulatory resource capabilities.

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