Clinical Liaison - Revenue Integrity - Maitland

  • Adventist Health System
  • Orlando, FL, USA
  • Jan 15, 2018

Job Description

Clinical Liaison - Revenue Integrity - Maitland
Florida Hospital seeks to hire a Clinical Liaison who will embrace our mission to extend the healing ministry of Christ.

Facility Profile:
Established in 1908, Florida Hospital is one of the largest not-for-profit healthcare systems in the country, caring for more than a million patients each year. The 2,286-bed acute-care medical facility, comprised of eight hospitals, has been recognized by U.S. News & World Report as one of the best hospitals in the country for the past 10 years. It serves as a community hospital for Greater Orlando and as a major tertiary referral hospital for Central Florida and much of the Southeast, the Caribbean and Latin America.

Work Hours/Shifts:
Full Time: Monday - Friday 8am - 5pm

Job Summary:
The Clinical Liaison (Liaison) is responsible for accurate and compliant charge capture through the evaluation and appropriate maintenance of all ambulatory and acute clinical operational processes. The Liaison ensures all aspects of the chargemaster for assigned departments is accurate and compliant with clinical guidelines, regulatory and billing requirements, and the Liaison completes department reviews and charge audits. Through reviews and/or interaction with clinical areas, the Liaison identifies charge capture opportunities and works with clinical areas to implement processes to accurately capture charges. The Liaison utilizes his/her knowledge of clinical information systems and the impact on charge capture in his/her daily responsibilities. Adheres to Florida Hospital Corporate Compliance Plan and to rules and regulations of all applicable local, state and federal agencies and accrediting bodies. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
Knowledge, Skills, Education, & Experience Required:
  • Ability to work and meet deadlines in a fast-paced, dynamic, project-oriented environment through organization and time management skills
  • Ability to relate operational performance in the healthcare environment and to present information to all levels of management.
  • Advanced end user computer skills; MS Office including Word, PowerPoint, Excel and Outlook; Windows operating system and Internet..
  • Extensive understanding of CCI edits, CPT codes, HCPCS codes, ICD codes, and Universal Billing Guidelines.
  • Extensive knowledge of Registration, Medical Records Coding, Government, and Managed Care billing rules, coverage, payment, and compliance.
  • Ability to read medical charts or dictation, understand services performed, and correlate those services to charges on the bill (UB-04).
  • Self-motivation, detail oriented focus, and outstanding customer service skills.
  • In-depth knowledge and ability to navigate hospital's multiple information systems; Examples include Suncare, EOS, Contract Management, CERNER & the Intranet. (Preferred)
  • Knowledge of FH Chargemaster system and the impact changes in the chargemaster has on the FH Clinical departments and Revenue Cycle. (Preferred)
  • Navigate in DDE (online Medicare billing). (Preferred)
  • Bachelor's degree in healthcare, business, or related field, OR
  • 5 years' clinical experience
  • Minimum 5 years' experience in healthcare or related field, with specific emphasis on billing/coding and/or revenue cycle clinical operations.
  • Bachelor's degree in relevant field, as defined above

Licensure, Certification, or Registration Required:
  • Current registration, licensure, or certification with Florida State Board of Nursing or Florida State Dept of Health and Human Services (or other accrediting entity, depending on clinical field)
  • Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) or Certified Professional Coder (CPC). (Preferred)

Job Responsibilities:
Demonstrates through behavior Florida Hospital's Core Values of Integrity, Compassion, Balance, Excellence, Stewardship, and Teamwork as outlined in the organization's Performance Excellence Program
  • Serves as a liaison to bridge the gap between clinical areas, finance, and revenue cycle departments. Works pro-actively with administration, finance, revenue cycle departments, nursing, and ancillary management to assure appropriate clinical business performance
  • Evaluates clinical department charge capture processes, department functions, and revenue flows that relate to charge capture to ensure appropriate charge capture and compliance with billing and regulatory guidelines.
  • Performs charge reviews and audits in assigned clinical areas for accurate charge capture, interacting closely with the Revenue Integrity Charge Auditors in identifying and correcting charge related errors, delivering summary report and recommendations, and working with clinical area leaders to implement process improvements, as needed, to improve charge capture accuracy.
  • Interacts with internal/external audit teams to review charging practices. Analyzing internal/external trends to determine educational, system, and/or process gaps.
  • Supports clinical information systems ensuring design, maintenance, and utilization complies with charge capture goals.
  • Remains current on regulatory and billing guidelines as well as standards of clinical practice for assigned area(s). Updates chargemaster and clinical ordering screens to ensure compliance with state regulatory requirements staying current with changing ICD, CPT, HCPCS, Revenue codes and other medical necessity guidelines and payer regulations including but not limited to accurate descriptions, coding, additions, and other miscellaneous changes.
  • Maintains a working knowledge of revenue cycle process to aid in the implementation of regulatory standards that assist the health system in cash collection while accurately complying with billing guidelines related to clinical processes.
  • Provides clinical department education for all new charge capture projects related to revenue cycle initiatives working closely with other revenue cycle departments to ensure projects are completed timely and accurately.

If you want to be a part of a team that is dedicated to delivering the highest quality in patient care, we invite you to explore the Clinical Liaison opportunity with Florida Hospital and apply online today.

Job Keywords:
Clinical Liaison, PFS, Maitland