Specialty Hospital Revenue Cycle Liaison

The Specialty Hospital Revenue Cycle Liaison is responsible for managing the complete revenue cycle for designated hospital specialty contracts. This role ensures accurate patient registration verification, insurance eligibility and benefits verification, medical coding, claims follow-up, and specialized hospital invoicing. This position serves as the primary liaison for assigned hospital contracts, ensuring timely reimbursement, accurate billing, and compliance with payer and contractual requirements.

Responsibilities

Verify patient demographics and insurance eligibility prior to services; Review and update patient registration information to ensure billing accuracy; Perform insurance verification, benefits investigation, and authorization review as required; Assign accurate ICD-10-CM, CPT, and HCPCS codes in accordance with coding guidelines and payer requirements; Review documentation to ensure coding accuracy and compliance; Submit and monitor claims for assigned hospital specialty contracts; Perform post-billing follow-up with insurance carriers regarding claim status, denials, appeals, and payment discrepancies; Research and resolve billing edits, denials, and underpayments; Prepare and submit specialty invoices to hospital clients according to contractual billing requirements; Reconcile payments and maintain accurate financial records for assigned accounts; Communicate with hospital representatives regarding account status, billing questions, and outstanding invoices; Maintain compliance with HIPAA, CMS regulations, payer policies, and organizational procedures; Generate reports and monitor key performance indicators related to revenue cycle performance; Assist with process improvement initiatives to maximize reimbursement and reduce claim turnaround time; Perform other duties as assigned

Requirements

High School Graduate or GED required; Minimum of 2 years of experience in medical billing, coding, and revenue cycle management; Knowledge of ICD-10-CM, CPT, HCPCS, and medical billing regulations; Familiarity with commercial, Medicare, and Medicaid insurance plans; Experience with electronic medical records (EMR) and practice management systems; Strong analytical, organizational, and problem-solving skills; Excellent communication and customer service skills; Ability to manage multiple specialty accounts while meeting deadlines with a high degree of accuracy; Reliable access to high-speed internet

Nice to have

EMT or Paramedic with a minimum of 2 years of field experience; Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or similar certification; Experience with hospital or specialty physician billing