Clinical Practice Specialist 3, Specialty Liaison

Overview

The successful candidate for this position will become a subject matter expert in all areas relating to revenue cycle management with a specific focus on providing ongoing analysis of the health of the revenue cycle for Yale Medicine and assigned clinical specialties with the goal of improving billings and collections and resolving coding, billing, and payer/contracting issues that may be impacting the revenue cycle.

Required Skills And Abilities

• Ability to analyze and interpret detailed reports, develop clear conclusions and summarize findings;
• Ability to perform quality assurance on individual accounts, monitor and analyze clinical department and payor key performance indicators and metrics for revenue cycle;
• Ability to work effectively as a team member; demonstrated team-building skills and ability to develop good working relationships with co-workers and Yale Medicine clinical departments;
• Ability to work, plan, research, and conduct projects independently with minimal supervision;
• Ability to organize and prioritize workload to manage multiple tasks and meet deadlines;
• Excellent written and oral communication skills with demonstrated interpersonal ability to facilitate a team based approach.

Preferred Skills And Abilities

• Comprehensive knowledge of ICD-10, CPT-4 and HCPCS coding, medical terminology and third party reimbursement policies;
• Proficiency with MS Word, Excel and PowerPoint;
• Proficiency with Epic Practice Management System and EMR;
• CPC certification, work related experience in a private or academic setting.

Principal Responsibilities

• Regularly reviews billing activity or specific clinical departments or sections. Provides comprehensive, detailed summary of findings (payment history, rejection analysis, frequency and status of unpaid claims, etc.). Communicates and provides regular updates to administration, physicians and coders.
• Provides advice on operational improvement to enhance efficiency of payment and overall reimbursement of clinical services.
• Develops, implements, and monitors policies and procedures to optimize provider reimbursement. Functions as a resource and educator for clinical department physicians and all appropriate staff on billing and coding issues by department.
• Develops training or educational programs and working manuals on procedural guidelines and implementation of new regulatory standards and initiates changes as contracts and regulations change.
• Collaboratively establishes policies and procedures to resolve issues around claims that are rejected, nor responded to, underpaid, etc. Provides recommendations on how to reduce rejections to improve collections.
• Researches policies of payers and communicates changes as appropriate. Maintains regular interactions and communication with third party payers.
• Led and/or assists with the management and/or performance of ongoing reimbursement projects, including but not limited to in-depth analysis of variances and tracking/managing issues with carriers.
• Performs coding audits, assesses risk and communicates findings.
• Ensures compliance with University, governmental and all third party regulations, including claim submission, coding accuracy and documentation to support billing. Performs quality assurance processing and assesses degree of risk for non-compliance with internal audit findings.
• Manages and coordinates decisions on optimizing output of subordinates and colleagues in producing information.
• May manage staff of both exempt and non-exempt employees.
• May perform other duties as assigned.

Required Education and Experience

• Bachelor’s Degree in Health Care Administration or RN and four years of related work experience or an equivalent combination of education and experience.

Required License(s) or Certification(s)

• Required License(s) or Certification(s):

Job Posting Date

07/27/2026

Job Category

Manager

Bargaining Unit

NON

Compensation Grade

Administration & Operations

Compensation Grade Profile

Supervisor; Senior Associate (24)

Salary Range

$68,000.00 - $120,500.00

Time Type

Full time

Duration Type

Staff Work Model

Remote

Staff Work Model

Background Check Requirements

All candidates for employment will be subject to pre-employment background screening for this position, which may include motor vehicle, DOT certification, drug testing and credit checks based on the position description and job requirements. All offers are contingent upon the successful completion of the background check.

Health Requirements

Certain positions have associated health requirements based on specific job responsibilities. These may include vaccinations, tests, or examinations, as required by law, regulation, or university policy.