Accounts Receivable Liaison

An Accounts Receivable Liaison (ARL) is responsible for gathering and analyzing accounts receivable data and reporting information by way of Business Intelligence to the Director and Team Leaders weekly. The ARL is responsible for meeting established daily, weekly and monthly Key Performance Indicators based on their accounts receivable oversight. This individual develops and implements new procedures to improve the quality and quantity of the CEO’s production against benchmarks on an ongoing basis. The ARL has responsibility of the oversight and management of CBO vendors. The ARL holds leadership responsibilities with indirect supervisory oversight of offsite vendor staffing. Working closely with the executive and leadership teams at FHN, the ARL is responsible for the Bad Debt and Charity expense to budget along with 501r federally mandated requirements and FHN’s Financial Assistance policy and procedural updates. The ARL manages the highest and most complex billing and coding patient concerns through to written or verbal closure. The ARL is a go to for day-to-day operations questions and coordinates work for other team members. This individual enters and maintains provider enrollment procedures in several internal and external portals serving as an authorized official for providers, maintaining enrollment requirements and updates. Creates NPIs for providers and facilities to ensure enrollment deadlines are met to bill for providers and facilities both new and existing.

Job Responsibilities
Charity Care program management and oversight – Analyzes applications and determines approval or denial requesting additional information on applications as necessary and answers patient questions. Updates, implements, and communicates financial assistance policy and procedure changes in order to be in compliance with State and federal guidelines including 501r.   Provides backup to Presumptive case reviews and process.
Provides financial assistance advocacy and education – Cancer Center Oncology Navigator meets with new chemo patients, and identifies funding through Foundations/Pharma programs.  Certified Application Consultant (CAC) enrolls qualified patients in Medicaid and ACA Marketplace insurance.  Meets face to face with uninsured inpatient and ED patients to provide financial assistance.
Oversees provider enrollment for each new billable provider and facility across acute, ambulatory, and FCC.  Authorized official for providers in CAQH, IMPACT, NPPES, payer portals, etc. to enroll, update, maintain, and terminate provider and facility information.  Manages/maintains a universal provider roster.  Coordinates with Medical Staff Services, Human Resources, and providers as needed.  Uses and maintains information within MDStaff and Meditech related to provider enrollment.  Reviews claims on hold due to pending enrollment and escalates enrollment delays with the various payer representatives.  Researches and trouble shoots denials related to provider enrollment, licensure, etc. to assist billing staff and leadership as needed.
Develops and implements methods to resolve Accounts Receivables and reduce AR Days.  Develops and implements departmental policies and procedures; including benchmarks, production, and quality standards. Works with key executives, marketing, and our attorney.  Identifies opportunities to reduce expense and implements necessary changes.  Develops, monitors, re-evaluates and implements new methods to maximize efficiency and production. High caliber special projects for this individual are established annually that take extensive planning, project management, testing and communication.
Managed care contracting reviews, updates, new contracts, etc. Strata contract management tool, chargemaster management and charge increases, reimbursement review, billing accuracy, etc.  Coordinates with systems team as needed to provide data related to reimbursement, and contracting agreements.
Early out vendor and collection agency management and oversight – Manages outside vendor relationships including patient statement vendor, self-pay, and collection agencies (primary and legal agencies).  Oversees Self Pay and Collection agency vendor productivity, cash collections, bad debt transfers to target, aging, and process workflows.  Works agency reports including acknowledgements, settlement, garnishment requests, account questions, certified lien letters, legal transfers, judgments, and reconciliations.  Provides vendor support through status calls, emails and onsite visits.
Monitors, gathers, and analyzes accounts receivable KPIs daily, weekly, and monthly to ensure established goals will be met across responsible payers and vendors. Creates and prepares reports. Provides data to outside vendors (daily or monthly) that manage portion of the Accounts Receivable.
Coaches and mentors new and existing offsite vendor staff members and onsite staff members.  Performs quality call monitoring for new and existing staff members including outside vendor partners.  Assists internal customers with questions about the Revenue Cycle.  Educates new hires during HWO on Financial Assistance.  New employee Self-pay job shadow.  Provider orientation.  Schedules new hire orientation.  Performs quality analysis of customer service tools and workflows.
Manages and Oversees Billing Patient Concerns – Resolves and manages complex accounts and billing/coding patient concerns including escalation and timely verbal/written responses to patients in accordance with CMS guidelines.  Concerns include Self-pay or bad debt collection challenges or supervisor reviews.  Provides Hospital Cashier’s Office back up, monitors and retrieves ED voicemails, Customer Service call overflow, help at front desk, and CBO Help desk.
Retrieves financial reports for leaders – Aging AR days, Charges, Payments and Adjustments, Avoidable Write Offs for all facilities, denials, claims filed, AR days, and emailed income reports from multiple modules to add information to the Balance Score Card.  Pull and monitor financial assistance adjustments to budget for the executive team.  Review the income statement to monitor department budget, contractual, bad debt, and Assisted Care amounts to budget.   Pull the Responsibility Report to track monthly expenses and monitor budget. Review vendor invoices and send to appropriate persons for approval and payment.
Other misc. responsibilities include: Updating and posting Stop light report on communication board, Scheduling meetings, creating agendas and taking minutes, supply management and tracking, tracking HFMA CRCR licensure and initial certification and recertification, complete Environment of Care, tracking credit card fees from all vendors, enter facility work orders, update the Communication board with updated Delivering Excellence information, and testing and staff readiness/training of multi-system updates.
Assists with preparing the annual department budget for individual operating expense, key vendor annual expenses and any quotes for new capital items or following year vendor changes.  Verifies, validates, and ensures accuracy of vendor invoices.
Qualifications
Requirements

Education: Associates Degree required; Bachelor’s Degree preferred

Required Experience: 5 – 8 years

Special Skills and Abilities:

Prior Revenue Cycle Experience (Insurance or Healthcare environment) with proven experience in the healthcare insurance arena, such as in the claims adjudication or customer service departments.
Exemplary oral and written communication, customer service and interpersonal skills required.
Proficiency with DRG, CPT, HCPCS, and ICD-10 coding required.
Fluent in Government and Managed Care billing requirements and reimbursement guidelines along with Patient Friendly billing guidelines, HIPAA, and provider enrollment requirements.
Working knowledge of insurance reimbursement practices for hospital, physician, cancer, and behavioral health.
Basic accounting principles, strong analytical and problem-solving skills needed.
Must have ability to balance multiple priorities, effectively handle challenging situations and successfully project manage large tasks/projects.
Licensure/Certification/Registration: HFMA CRCR (Certified Revenue Cycle Representative) required