Revenue Integrity Clin Liaison

Orlando Health•Orlando, FL

17h•Hybrid

About The Position

The Revenue Integrity Clinical Liaison is responsible for ensuring that the service line captures all appropriate revenue by continuously monitoring regulatory and compliance rules set by Medicare and other payers. They identify revenue opportunities and develop plans to improve processes throughout the revenue cycle, aiming to increase revenue capture and reduce denials. The liaison facilitates the removal of communication barriers within the Revenue Integrity Department to minimize process overlaps and enhance communication, thereby improving overall workflow.

Requirements

Bachelor’s degree preferred in related field or; An Associate degree and two (2) years of directly related work experience may substitute for the bachelor’s degree or four (4) years of directly related work experience may substitute for the bachelor’s degree, in addition to items listed in the experience section.
Four (4) years of clinical or hospital experience and one (1) year 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.

Responsibilities

Ensure timely budget-compliant goals are achieved and align with regulatory guidelines and methods.
Assist Revenue Cycle areas in project completion, modifications, and general oversight.
Establish and maintain collaborative relationships with peers, Administration, CFOs, Managers, and site contacts.
Collaborate with IS, Nursing and Revenue Management departments in the process improvement and implementation of charge capture opportunities.
Develop relationships with committees and groups to ensure continuity in revenue capture processes.
Represents the Revenue Integrity department professionally in all settings.
Maintains an ongoing database of contacts from each site for each department to include the charge entry system being used.
Assists all departments in understanding their responsibility to perform daily charge capture and reconciliation processes for their departments.
Maintains, execute, and implement downtime procedures to assist departments knowledge, responsibility, and procedures during system configurations/updates of specific to their service charge line.
Reports capture successes as they occur.
Maintain assigned policies, procedures and manuals.
Prepare and distribute executive summaries on revenue capture process improvements.
Foster trusting relationships to encourage revenue capture opportunities and 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.
Provides resource guidance to assist in education and understanding of regulatory rules, charge capture, and reconciliation.
Performs other duties as assigned.