Covenant Health

Patient Account Billing Liaison, CMG Business Office

Full time, 80 hours per pay period, Day shift

Covenant Medical Group is Covenant Health’s employed and managed medical practice organization, with more than 300 top Physicians and providers spanning the continuum of care in 20 cities throughout East Tennessee. Specialties include cardiology, cardiothoracic surgery, cardiovascular surgery, endocrinology, gastroenterology, general surgery, infectious disease, neurology, neurosurgery, obstetrics and gynecology, occupational medicine, orthopedic surgery, physical medicine and rehabilitation, primary care, pulmonology, reproductive medicine, rheumatology, sleep medicine and urology.

Position Summary:

Demonstrates knowledge of Medicare and payer billing guidelines and policies. Demonstrates ability to promptly review, interpret and communicate current and changes to published Medicare and other payer billing guidelines/policies. The Billing Liaison must be able to answer policy guideline questions and provide documentation of the billing guideline. The position is responsible for daily review of end of day charge reports for all CBO offices to monitor for specific errors.

Interpersonal Skills, Personal Traits, Abilities and Interests:

Ability to review and disseminate information from Medicare and other Payers to CMG offices.  Strong verbal and written communication skills required. Communication with CBO Operation Managers and Director of Revenue Cycle regarding changes in Medicare and other payer billing guidelines/policies.  The Billing Liaison must be able to answer policy guideline questions and provide documentation of the guideline.  The position is responsible for daily review of end of day charge reports for all CBO to monitor for possible errors. Much attention to detail and the ability to interpret guidelines is required.  Ability to create reports related denials, errors and other related work sheets. 

Recruiter: Kathleen Rice || kkarnes@covhlth.com || 865-374-5386

• Serves as resource to CMG operations to review for additions and deletions of CPT codes. Submits CPT add/change form for new codes to obtain pricing and additions to computer systems. Responsible for SIM chargemaster for CMG.
• Receives and interprets Medicare and other carrier billing guidelines updates. Communicates to Director or Revenue cycle and/or CBO Operations Manager so information can be distributed to proper departments/staff. 
• Maintains Mail SharePoint, MLN Matters, LCD’s, and all other written correspondence on a shared drive for access by CBO staff. 
• Review, approve/decline, and process refund requests.  
• Attends all payer meetings concerning Medicare and other payor compliance. 
• Performs other duties as assigned to the satisfaction of the CBO Operations Manager and/or Director of Revenue Cycle. 
• Does not promote or participate in solicitation during working hours within the department. 
• Identifies possible coding problem areas that need stronger focus and/or resolution. 
• Reviews CMG wide end of day reports for issues in charge entry. Under direction from CBO Operations Manage provides guidance to office staff for correction of charge entry errors.  
• Analyzes claim denials, looking for trends. Investigates errors. Reports findings to CBO Operations Managers for guidance.
• Tracks and trends billing errors discovered in practice management system and clearing house. Reports findings to CBO Operations Manager.  Under direction of CBO Operations Manager presents feedback to practices responsible for errors.
• Serves as a resource to the CBO and other CMG offices regarding charge issues and billing requirements. 
• Assists patient accounts staff in resolving coding issues on claims. Investigates accounts with improper match of diagnosis and procedure codes to facilitate proper reimbursement.  Educate office staff regarding proper linkage of diagnosis with a billed service.
• Consults and works collaboratively with CBO Operations Managers, co-workers, and other office personnel, effectively performing tasks of position. 
• Promotes good public relations for the department adhering to desired behaviors. 
• Communicates effectively with Management, co-works and other personnel using verbal, nonverbal and written communication skills. 
• Assists the CBO managers and Director of Revenue Cycle on activities and projects, as needed. 
• Attends in services and other meetings as required to enhance professional growth and development.
• Provides assistance to new employees. 
• Participates freely in intradepartmental activities whenever called upon to do so.
• Follows policy and procedures as established by CMG.
• Demonstrates promptness in reporting for and completing work – ensuring follow through on assigned tasks. 
• Demonstrates appropriate utilization of resources, i.e. Equipment and supplies. 
• Perform other duties as assigned or requested.

Minimum Education:          

None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED.   Preference may be given to individuals possessing an Associates degree in a directly-related field from an accredited college or university or a Coding Certification.

Minimum Experience:            

Minimum of three year (3) of business office or related experience with knowledge of Medicare and managed care billing guidelines.  Strong computer skills required. Knowledge and/or ability to learn and utilize NextGen, Greenway and Gateway systems, as well as Microsoft Office.   Requires strong interpersonal skills and clarity in written and oral communications. 

Licensure Requirement:      

None