Reimbursement Account Liaison Specialist

1 week ago

Memphis, Tennessee, United States Anovorx Group LLC Full time
Job Title: Reimbursement Account Liaison

Job Summary:

The Reimbursement Account Liaison plays a critical role in managing the financial activities of patient payers, ensuring seamless claims processing and reimbursement. This position requires strong communication and interpersonal skills, as well as the ability to analyze and resolve complex reimbursement issues.

Key Responsibilities:

  1. Monitor and report reimbursement trends and issues to managed care organizations and departments.
  2. Maintain working relationships with payer parties, including insurance companies and government agencies, to resolve slow payment issues and reimbursement problems.
  3. Communicate with patients, families, doctors, and office personnel to answer medical billing inquiries and provide coverage information.
  4. Track denials and underpayment occurrences within the database.
  5. Regularly report to management on payer policies, rates, procedures, and changes that impact the company.
  6. Participate in meetings to update staff on progress, problems, and suggestions for improving service quality and processes.
  7. Identify and develop professional relationships with potential customers.
  8. Coordinate with account teams to ensure business success.
  9. Provide excellent customer service to ensure customer satisfaction.
  10. Manage front-end paperwork for customer accounts.
  11. Coordinate and manage customer account documentation.
  12. Document, track, and resolve plan providers' billing and payment issues.
  13. Research and respond to providers' claims inquiries.
  14. Collaborate with business units to resolve claims issues and provide instruction on claims submission policies and procedures.
  15. Identify authorization issues and trends.
  16. Direct and educate Provider Services and Relations on claims reprocessing notifications.
  17. Analyze trends in claims processing issues and assist in identifying and quantifying issues and reviewing work processes.
  18. Identify providers experiencing claims issues and proactively work to eliminate barriers for accurate and timely claims processing.
  19. Notify applicable departments to resolve eligibility issues.
  20. Meet with providers to discuss claims payment policies and procedures and resolve claims issues.
  21. Handle provider additions, changes, and terminations.
  22. Run claims reports regularly through provider information systems.
  23. Assist the supervisor with compiling and preparing data for the Daily Dedicated Dashboard reporting.
  24. Report on current patient statuses in the Dedicated Pharmacy Dashboard meetings.

Requirements:

  1. Bachelor's degree or related experience required.
  2. At least 4 years of relevant experience and strong knowledge base in healthcare policy and reimbursement for all payer types, including Commercial, Medicaid, and Medicare.
  3. Experience with relationship-building with customers.
  4. Relevant work experience to give presentations, audio conferences, and face-to-face visits.
  5. Strong organizational skills.
  6. Extremely detail-oriented.
  7. High level of professionalism.
  8. Strong customer service skills.
  9. Excellent written and verbal communication skills.
  10. Excellent computer skills - MAC or PC.
  11. Strong spreadsheet and database management.

This description is intended to be only a general outline of major activities. It is expected that the employee performs these and any other activities which may be assigned, or which may occur in the normal course of work. AnovoRx is an Equal Opportunity Employer.

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