Revenue Cycle Liaison

Revenue Cycle Liaison

The Revenue Cycle Liaison serves as the primary liaison between clinic operations and centralized revenue cycle teams, ensuring accurate, timely, and compliant revenue capture. This role focuses on front-end and operational workflows that impact billing, reimbursement, and cash flow, including registration accuracy, eligibility verification, charge capture, and issue resolution. This role is responsible for overall FQHC revenue cycle system analytics, troubleshooting, and fix implementation and interfaces with key leaders in PHMC's Health Center Practice Management, Information Technology, and Finance teams as well as an outsourced revenue cycle vendor. The Revenue Cycle Liaison is responsible for identifying workflow gaps in the revenue cycle via on-site observation or analytical review and reporting them to the appropriate leadership counterpart. They are a strategic partner in recommending potential solutions in those identified workflow gaps. This role supports the clinical operations of Medical, Dental, Behavioral Health, and Podiatry with billable revenue exceeding $20M. Additional service areas may be added, dependent on FQHC's scope of service growth.

The Revenue Cycle Liaison proactively identifies revenue risks, supports clinical teams with education and process improvement, and partners with Outsourced Billing Vendor, Finance, Operations, Information Systems, and Compliance to resolve systemic issues impacting reimbursement and patient experience.

The Revenue Cycle Liaison reports to the Managing Director of Finance for Billing.

Responsibilities:

• Serves as the primary liaison between clinic operations and centralized billing teams
• Tracks, escalates, and resolves site-level front-end revenue cycle issues
• Facilitates timely communication between clinic leadership and billing to ensure issues are addressed and closed
• Supports root-cause analysis of recurring revenue cycle issues and partners on corrective action plans

Front-End Revenue Integrity:

• Supports clinic teams in maintaining accurate patient registration, insurance verification, eligibility confirmation, self-pay, and sliding fee discount compliance
• Monitors front-end workflows that impact billing accuracy and reimbursement
• Reinforces standard operating procedures for front-desk, enrollment, and clinic support staff
• Partners with Enrollment and site teams to address coverage gaps and payer transitions
• Has regular on-site presence at Health Centers for front-end workflow observation, troubleshooting, and training

Charge Capture & Documentation Support:

• Works with clinical and operational staff to ensure services are appropriately documented, and charges are submitted accurately and timely
• Supports implementation and adherence to charge capture workflows aligned with payer and FQHC requirements
• Identifies trends related to missing, late, or incorrect charges and collaborates with finance leadership to address gaps
• Acts as a bridge between clinical operations and billing, optimizing reimbursement by auditing charge capture, resolving coding-related denials, and educating staff on documentation improvements; analyzes denial trends, ensures compliant coding (CPT/ICD-10), and facilitates communication to maximize revenue

Data Monitoring & Reporting:

• Reviews revenue-related dashboards and reports to identify trends, risks, and opportunities at the site or regional level
• Prepares summary reports for Operations and Finance leadership, highlighting key issues, resolutions, and outstanding risks
• Works with Billing Vendor and Finance to ensure cash payment posting is completed in an accurate and timely manner
• Supports ad hoc data requests related to revenue performance and workflow improvement

Education, Training & Change Support:

• Provides ongoing education and coaching to clinic teams on revenue cycle, related workflows, and best practices
• Supports onboarding and training for new clinic staff related to registration, eligibility, and revenue-sensitive processes
• Assists with the implementation of new workflows, systems, or payer requirements impacting revenue cycle operations

Compliance & Audit Support:

• Partners with Compliance and Finance teams to support audit readiness related to billing, documentation, and front-end processes
• Assists with corrective action plans resulting from audits, OSVs, or internal reviews
• Ensures revenue cycle practices align with HRSA Health Center Program requirements, Medi-Cal, Medicare, and payer contracts

Cross-Functional Collaboration:

• Collaborates closely with Clinic Operations, Enrollment, Access, Quality, IT, and Compliance teams
• Serves as a resource for Center Directors and site leadership related to revenue cycle questions and escalations
• Collaborates in a strong partnership with the Deputy Director of the Health Centers, Practice Managers, and Front-end teams
• Collaborates regularly with Information Systems to prioritize, manage, resolve, and implement JIRAs
• Participates in meetings, workgroups, and improvement initiatives as assigned

General Administration:

• Documents issues, resolutions, and process changes to support transparency and continuous improvement
• Performs other duties as assigned to support organizational revenue integrity and sustainability

Qualifications:

• Strong attention to detail with the ability to identify revenue risk early
• Ability to translate revenue cycle requirements into operational workflows
• Comfort working in fast-paced, highly collaborative environments
• Commitment to equity, access, and patient-centered care
• Professional judgment and discretion when handling sensitive financial information
• Sound judgment escalating issues to site leadership, financial leadership, and/or enterprise leadership as appropriate

Job Requirements:

• Associate or bachelor's degree in healthcare administration, business, finance, or a related field, or equivalent experience
• Minimum of 3–5 years of experience in healthcare revenue cycle, clinic operations, or front-end registration/eligibility
• Working knowledge of ambulatory billing workflows, insurance eligibility, and payor processes
• Experience working with EHR and practice management systems
• Strong organizational, communication, and problem-solving skills
• Ability to work collaboratively across departments and with clinic staff

Job Preferences:

• Experience in an FQHC or safety-net healthcare setting
• Familiarity with Medicaid, Medicare, PPS, and managed care billing
• Experience supporting denial management or charge capture improvement
• Knowledge of HRSA Health Center Program requirements
• Proficiency with reporting tools (e.g., Epic Ochin, Excel, payor portals, others)
• Bilingual or multilingual skills reflective of the communities served

PHMC is an Equal Opportunity and E-Verify Employer.