Revenue Integrity Clin Liaison

Position Summary

HYBRID POSITION WITH TRAVEL INVOLVED!

At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our 27,000+ team members serve communities that span Florida's east to west coasts and beyond.

ORLANDO HEALTH - BENEFITS & PERKS:

All Inclusive Benefits (start day one)

• Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility benefits, back up elder and childcare, pet insurance, PTO/Holidays, and more for full time and part time employees.

Forbes Recognizes Orlando Health as a Best-In-State Employer

• Forbes has named Orlando Health as one of America's Best-In-State Employers for 2024. Orlando Health is the top healthcare organization in the Metro Orlando area to make the prestigious list. "We are proud to be named once again as a best place to work," said Karen Frenier, VP (HR). "This achievement reflects our positive culture and efforts to ensure that all team members feel respected, supported and valued.

Employee-centric

• Orlando Health has been selected as one of the "Best Places to Work in Healthcare" by Modern Healthcare

Position Summary:
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.


Responsibilities

Essential Functions
• 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.

Other Related Functions
• Provides resource guidance to assist in education and understanding of regulatory rules, charge capture, and reconciliation.
• Performs other duties as assigned.


Qualifications

Education/Training:
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.

Experience:
• 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.