In the role of Practice Service Liaison, you will be working in Clinical Practice Services (CPS). The Practice Services Liaison collaborates with Department Administration, Providers, CPS Billing and Collection staff, and related Froedtert clinics and ancillary areas to improve processes and maximize collections for the assigned specialties following regulatory and compliance requirements. Manages claims’ matters related to front-end and back-end revenue cycle processes such as patient registration, managed care referrals/ prior authorizations, charge capture, medical record documentation, coding and billing, claims adjudication and accounts receivable (AR) follow-up for payment and denial resolution. Utilizes coding principles and specific coding knowledge to identify opportunities to improve reimbursement. Analyzes AR and monthly financial reports to track key indicators to keep clinical department faculty and CPS informed of financial statistics. Safeguards or strengthens existing relationships.
All remote work must be performed within one of the MCW registered payroll states, which currently includes: WI, AZ, FL, IL, IN, MD, MI, MN, MO, NC, TN,TX, and UT.
Responsibilities:
- Assist Clinical Department(s) and/or CPS seeking to learn more or resolve a suspected concern, generally of a clinical and/or financial nature. Lead the follow up with others along with requesting and analyzing relevant data.
- Pursue understanding of the relevant charge capture processes within the affected Clinical Department(s) and CPS. Includes relevant charge and documentation interfaces, fee schedule and contracts.
- Augment normal CPS claims analysis and appeal procedures through follow-up on self-generated reports and other current standard system reports to identify appeal tactics and escalation measures. Prepare appeal defense and submit appeals consistent with the AR follow up team protocols.
- Report findings of positive and negative trends. Offer suggestions for improvement and develop action plan. Prepare supporting documentation that illustrates the impact on the revenue cycle or improvement to an existing process within CPS or the Clinical Department(s).
- Act as the point-of-contact for communications to and from the assigned Department(s) including, but not limited to being a resource to the department management and faculty on questions on codes, coding, billing, documentation, denials, reimbursement, and payer policy.
- Identify the need for and participate in the development of departmental policies and/or processes involving complex or potentially sensitive issues, as requested.
- For new CPT codes or new services performed, research accurate reporting, expected reimbursement and documentation requirements using authoritative sources. Collaborate with Charge Capture Management and EPIC teams on charge capture set up.
- Act as a resource to the coding specialists and provide education, training or audit their performance as necessary to minimize denials and defend the maximum reimbursement.
- Provide CPT coding support to prevent disruption of workflow to CPS as necessary.
- Participate in new provider orientations.
Knowledge – Skills – Abilities
Experience extracting and abstracting data utilizing an electronic medical record. Experience navigating in a professional fee billing system environment, preferred. Working knowledge of Excel, preferred. Knowledge of quality control, customer service standards, information management, procedural process, and recordkeeping. Computer, technical, interpersonal, oral communication, listening, and patience skills.
Preferred Schedule:
Full-time role with expectations for coverage during core business hours and flexibility required as necessary to accommodate business needs.
Position Requirements:
Minimum Qualifications:
Appropriate experience may be substituted for education on an equivalent basis
Minimum Required Education: Bachelor’s degree
Minimum Required Experience: 4 years
Preferred Qualifications:
Preferred Education: Coding Certification (CPC, CCS-P, RHIA, RHIT)
Field: CPT and diagnosis coding, relevant specialty coding experience preferred, payer policy review, health insurance follow up
Why MCW?
- Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental. Along with Flexible Spending options
- 403B Retirement Package
- Competitive Vacation and Paid Holidays offered
- Tuition Reimbursement
- Paid Parental Leave
- Pet Insurance
- On campus Fitness Facility, offering onsite classes.
- Additional discounted rates on items such as: Select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment etc.
