Position Description: We're looking for those individuals-the creative thinkers and innovation seekers-who are content with nothing short of changing the world. Discover the endless opportunities within the Medical College of Wisconsin (MCW) and be inspired by the work we can do together to improve health, and make a positive, daily impact in our communities. In the role of Practice Service Liaison, you will be working in Clinical Practice Services (CPS). The Practice Services Liaison collaborates with Department Administration, Providers, CPS Billing and Collection staff, and related Froedtert clinics and ancillary areas to improve processes and maximize collections for the assigned specialties following regulatory and compliance requirements. Manages claims' matters related to front-end and back-end revenue cycle processes such as patient registration, managed care referrals/ prior authorizations, charge capture, medical record documentation, coding and billing, claims adjudication and accounts receivable (AR) follow-up for payment and denial resolution. Utilizes coding principles and specific coding knowledge to identify opportunities to improve reimbursement. Analyzes AR and monthly financial reports to track key indicators to keep clinical department faculty and CPS informed of financial statistics. Safeguards or strengthens existing relationships.Responsibilities:
- Assist Clinical Department(s) and/or CPS seeking to learn more or resolve a suspected concern, generally of a clinical and/or financial nature. Lead the follow up with others along with requesting and analyzing relevant data.
- Pursue understanding of the relevant charge capture processes within the affected Clinical Department(s) and CPS. Includes relevant charge and documentation interfaces, fee schedule and contracts.
- Augment normal CPS claims analysis and appeal procedures through follow-up on self-generated reports and other current standard system reports to identify appeal tactics and escalation measures. Prepare appeal defense and submit appeals consistent with the AR follow up team protocols.
- Report findings of positive and negative trends. Offer suggestions for improvement and develop action plan. Prepare supporting documentation that illustrates the impact on the revenue cycle or improvement to an existing process within CPS or the Clinical Department(s).
- Act as the point-of-contact for communications to and from the assigned Department(s) including, but not limited to being a resource to the department management and faculty on questions on codes, coding, billing, documentation, denials, reimbursement, and payer policy.
- Identify the need for and participate in the development of departmental policies and/or processes involving complex or potentially sensitive issues, as requested.
- For new CPT codes or new services performed, research accurate reporting, expected reimbursement and documentation requirements using authoritative sources. Collaborate with Charge Capture Management and EPIC teams on charge capture set up.
- Act as a resource to the coding specialists and provide education, training or audit their performance as necessary to minimize denials and defend the maximum reimbursement.
- Provide CPT coding support to prevent disruption of workflow to CPS as necessary.
- Participate in new provider orientations. Knowledge - Skills - AbilitiesExperience extracting and abstracting data utilizing an electronic medical record. Experience navigating in a professional fee billing system environment, preferred. Working knowledge of Excel, preferred. Knowledge of quality control, customer service standards, information management, procedural process, and recordkeeping. Computer, technical, interpersonal, oral communication, listening, and patience skills. Preferred Schedule: Full-time role with expectations for coverage during core business hours and flexibility required as necessary to accommodate business needs. Position Requirements: Minimum Qualifications:Appropriate experience may be substituted for education on an equivalent basisMinimum Required Education: Bachelor's degreeMinimum Required Experience: 4 years Preferred Qualifications:Preferred Education: Coding Certification (CPC, CCS-P, RHIA, RHIT)Field: CPT and diagnosis coding, relevant specialty coding experience preferred, payer policy review, health insurance follow up #LI-RT1 Why MCW?
- Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental. Along with Flexible Spending options
- 403B Retirement Package
- Competitive Vacation and Paid Holidays offered
- Tuition Reimbursement
- Paid Parental Leave
- Pet Insurance
- On campus Fitness Facility, offering onsite classes.
- Additional discounted rates on items such as: Select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment etc. For a full list of positions see: For a brief overview of our benefits see: Eastern Wisconsin is a vibrant, diverse metropolitan area. MCW is intent on attracting, developing, and retaining a diverse workforce and faculty body that reflects the community we serve. We value diversity of backgrounds, experience, thought, and perspectives to advance excellence in science and medicine. MCW is a welcoming campus community with a strong culture of collaboration, partnership, and engagement with our surrounding community. For more information, please visit our institutional website at . MCW as an Equal Opportunity Employer and Commitment to Non-Discrimination The Medical College of Wisconsin (MCW) is an Equal Opportunity Employer. We are committed to fostering a diverse community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants or other members of the MCW community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic. .