Gainesville, Florida, USA
11 days ago
Revenue Cycle Liaison | Billing & Accounts Receivables - BCBS | Day I Full Time
Overview Ensures the financial integrity of the UF Health and assigned Department(s) by ensuring continuous quality improvement of physician coding and team billing practices. Review of and recommendations for ICD-10/CPT coding to ensure compliance with institutional compliance policies for coding and claim submission, as well as payer guidelines. This includes: high-level data analysis, detailed research of complex denials, reporting for trended claim issues, reading and interpreting Managed Care payer contracts, and review reimbursement variance issues. Compiles detailed appeals containing documentation to substantiate effective reimbursement including: complex coding appeal language, substantial medical documentation and literature, and referencing specific payer guidelines supporting services billed. Qualifications Minimum Education and Experience Requirements: � High school graduate or equivalent, required. � 2 years of experience in hospital and/or physician billing practice required. � Associates degree may substitute for required work experience. � Coding certification preferred. � Ability to code for both diagnosis and procedure preferred. � EPIC system knowledge preferred. � Liaison must be comfortable speaking with physicians and payers regarding procedure and diagnosis relationships, billing rules, payment variances and have the ability to assertively set the expectation for review or change. � Liaison should be proficient in database software, such as Excel, EncoderPro, etc. Motor Vehicle Operator Designation: Employees in this position: Will not operate vehicles for an assigned business purpose NOTE: A frequent driver is defined as one who uses his/her personal or University of Florida Health automobile a) at least once daily, b) at least five individual trips per week or c) drives, on average, over 150 miles per week in the performance of his/her job. Licensure/Certification/Registration: None
Confirm your E-mail: Send Email