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Patient Financial Liaison

2 months ago

Memphis, Tennessee, United States Anovorx Group LLC Full time
Job Overview

Position Summary:

The Patient Financial Liaison plays a crucial role in overseeing the financial interactions with patient payers, ensuring a smooth process from the delivery of products or services to the conclusion of the payment cycle. This position serves as a vital link between sales teams, billing departments, and healthcare providers, managing all aspects of claims processing, including addressing disputes, delays, or denials. The ideal candidate will possess strong communication skills, independence, decisiveness, and interpersonal abilities, as they will engage with patients, government representatives, fiscal intermediaries, and partners in the pharmaceutical and managed care sectors.

Key Responsibilities:

  1. Analyze and report reimbursement trends and issues to relevant managed care organizations, while updating business services divisions on new contracts or renewals.
  2. Foster and maintain productive relationships with payer entities, including insurance companies and government agencies, to resolve slow payment and reimbursement challenges.
  3. Provide clear communication to patients, families, healthcare providers, and office staff regarding medical billing inquiries and coverage details for specific procedures.
  4. Monitor and track claim denials within the database to identify underpayment trends.
  5. Regularly update management on payer policies, rates, and procedures that may impact the organization.
  6. Participate actively in team meetings, sharing updates on progress and addressing any challenges while considering colleagues' suggestions for enhancing service quality.
  7. Build and nurture professional relationships with potential clients.
  8. Collaborate with account teams to drive business success.
  9. Deliver exceptional customer service to ensure client satisfaction.
  10. Oversee all preliminary documentation for customer accounts.
  11. Manage and organize customer account records.
  12. Document, track, and resolve all billing and payment issues related to plan providers.
  13. Investigate both verbal and written inquiries regarding providers' claims.
  14. Work with various business units to address claims issues and provide guidance to providers' billing staff on claims submission policies and procedures to ensure accurate and timely adjudication.
  15. Identify and address authorization issues and trends.
  16. Educate Provider Services and Relations on claims reprocessing notifications, leveraging knowledge of provider billing and claims processing.
  17. Examine trends in claims processing issues, assisting in identifying and quantifying challenges while reviewing work processes.
  18. Recognize providers facing claims challenges and proactively address barriers to ensure accurate and timely claims processing.
  19. Identify potential eligibility issues and notify relevant departments for resolution.
  20. Engage with providers to discuss claims payment policies and resolve any outstanding issues.
  21. Manage provider additions, modifications, and terminations as necessary.
  22. Generate regular claims reports using provider information systems.
  23. Assist supervisors in compiling and preparing data for daily reporting dashboards.
  24. Provide updates on current patient statuses during dashboard meetings.
  25. Maintain regular and reliable attendance.
  26. Perform other job-related duties as assigned by supervisors or managers.

Required Qualifications:

  1. Bachelor's degree or equivalent experience is required.
  2. A minimum of 4 years of relevant experience with a strong understanding of healthcare policy and reimbursement across all payer types, including Commercial, Medicaid, and Medicare.
  3. Proven experience in building relationships with clients.
  4. Experience delivering presentations via audio conferences and in-person meetings.
  5. Exceptional organizational skills.
  6. Detail-oriented with a high level of professionalism.
  7. Strong customer service orientation.
  8. Excellent written and verbal communication skills.
  9. Proficient in computer skills, including MAC or PC.
  10. Strong capabilities in spreadsheet and database management.

This description serves as a general outline of the primary activities associated with this position. It is expected that the employee will perform these and any other tasks that may arise in the normal course of work. This description does not constitute a contract or guarantee of employment. AnovoRx is an Equal Opportunity Employer.