Patient Accounts Liaison - Patient Financial Services Job Listing at MedStar Health in White Marsh, MD (Job ID 155840)

Description

About the Job

General Summary of Position
Coordinates Patient Financial Services (PFS) requests for medical records clarification of coding and compliance with Medicare billing guidelines for Local Medical Review Policies (LMRP).

Primary Duties and Responsibilities

• Reviews and follows up on uncoded and unbilled accounts pending on the Outpatient Billing Exception Report and the Inpatient Alpa Di Report pending for diagnosis and procedure code(s) greater than assigned bill hold.
• Works directly with Directors of Health Information Management (HIM) to discuss issues causing coding delays ensures timely filing and makes recommendations for improvement. Identifies issues and trends and facilitates the resolution of problems with the assistance of the Management team. Ensures compliance of CPT HCPCS and ICD-10 coding regulations and guidelines.
• Works with the Medicare Billing Team and Health Information Management Coding Managers who review outpatient accounts on a pre-billing basis for Medicare Local and National Coverage Determinations coverage edits related to billed diagnosis code(s). Searches the Medicare contractor and or the Centers for Medicare and Medicaid internet database to identify local and national coverage guidelines.
• Coordinates the receipt tracking and weekly reconciliation of various Medicare audits pertaining to the request of patient medical records for Additional Development Request (ADR) Probes Office of Inspector General (OIG) Payment Error Rate Measurement (PERM) and Comprehensive Error Rate Testing (CERT) request letters generated from the various billing systems mailed or faxed.
• Manages the process to submit requests to designated personnel in HIM of each assigned facility or print records from various systems where appropriate. Submits completed medical record requests timely to the designated Medicare Contractor. Escalates untimely receipts of medical record requests to department management team hospital CFO and PFS Directors as needed. Maintains a 1% fail rate of Medicare Technical Denials return of medical records to Medicare Contractor within 45 days.
• Works with Medicare Follow Up Team with timeliness referral of inpatient and outpatient full and partial denials to Case Management or designated Ancillary Department for appeal. Monitors and tracks various Medicare level of appeals refers accounts to bill Medicare Part B as appropriate and tracking appeal overturns. Processes all incoming full or partial self denial requests from Case Management referring accounts to the Medicare Billing team.
• Maintains ongoing knowledge of UB-04 and other mandatory state and Federal billing forms and filing requirements.
• Attends informal or scheduled staff meetings regarding policy and procedures. Meets or exceeds quality audit and assigned productivity goals.

Minimal Qualifications
Education

• High School Diploma or GED required 
• Associate's degree in healthcare preferred 
• Courses in Accounting Finance and Healthcare Administration preferred

Experience

• 5-7 years Experience in patient accounting health information management (HIM) or related field required

Knowledge Skills and Abilities

• Proficient use of hospital registration and/or billing or financial systems.
• Microsoft software: Word, Excel & Outlook.
• Excellent analytical and problem-solving skills.
• Ability to work independently.
• Strong commitment to quality and customer service.
• Excellent verbal and written communication skills.