PT ACCT BILLING LIAISON

Overview

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.

Responsibilities

• Serves as resource to CMG operations to review for additions and deletions of CPT codes.
• Sets up CPT add/change forms 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.
• Reviews, approves/declines, and processes 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.

Qualifications

• 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 years (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.