Radiation Patient Liaison Account Specialist

At Urology America, our mission is to support our physician partners in building a premier urology organization that delivers best-in-class patient care and experience, is nationally recognized for its clinical capabilities, and excels in operational performance and growth.

By choosing a career with Urology America and its affiliated practices, you are joining a collaborative, team-driven organization committed to innovation, quality, and compassionate care. Together, we are improving the lives of patients and their families through better medicine and better care, wherever we serve.

Job Summary:
The Patient Liaison analyzes and interprets documentation from medical records and completes accurate coding and billing of office-based diagnoses and procedures and professional fee coding of diagnosis and procedures, charge review, E/M assignment and charge router. The Patient Liaison communicates with providers for missing documentation or questions regarding documentation and offers guidance and education when needed. For professional fee coding, individuals in this role will be proficient for inpatient and outpatient, for multi-specialties. Patient Liaison utilizes the International Classification of Disease (ICD-10CM. ICD-10-PCS) and Physicians Current Procedural Terminology (CPT) coding systems and other coding references to ensure accurate coding. Ideal candidates will be proficient in three or more types of outpatient coding and possess a sound knowledge of medical coding rules, regulations, and compliance utilizing ICD 10 according to CMS guidelines. Ideal candidates will also possess strong knowledge of anatomy, physiology, and medical terminology as well as working knowledge of insurance processes and reconciliation regarding the denial process.
 

• This position is a remote position
• Reports to the Data Quality Assurance Manager and the physicians at Urology Austin.
• Works in conjunction with providers, other front office staff and 3^rd party billing vendor to provide proper check-out procedures for patients of Urology Austin.
• Maintains extensive contact with the revenue cycle team to ensure the proper flow of financial information.

• Preferred, three-year Coding experience in healthcare organization, Oncology experience preferred.
• Knowledge of insurance reimbursement procedures, CPT, ICD-10, HCPCS codes, along with charge entry payment posting, billing, and medical practice policies.
• High school diploma or equivalent required.
• College Education/Vocational Training in Medical Coding is preferred.
• Knowledge of computer/telephone support, preferably in a health care environment
• Strong customer service background, preferably in a health care environment.
• Excellent verbal communication skills.
• Competence with computer processing functions and other standard office equipment.
• Ability to manage and prioritize multiple tasks.
• Ability to adapt the departmental changes as delegated.
• Ability to calmly and professionally resolve customer issues with diplomacy and tact.
• Ability to work independently with minimal supervision.
• Strong organizational skills

• Adheres to service excellence and promotes a positive work environment.
• Ensure attached required documentation needed for clean charge submission.
• Abstract CPT, HCPCS, and ICD-10-CM from medical records, and assign appropriate diagnostic and procedural codes.
• Provide coding support and expertise in multiple departments throughout the company.
• Review Radiation therapy patient record documentation in ARIA to ensure orders and documentation are completed and approved in a timely manner,
• Determines documentation and orders match prescription and services provided.
• Obtain Necessary Authorizations for the following but not limited to, Radiation Therapy, Radiation Therapy surgical procedures, Immunotherapy, Radiopharmaceutical therapy.
• Obtain Referral for Radiation Therapy surgical procedures performed by the Urologists.
• Schedule, obtain authorization, go over pre-op instructions and send routes to Clinical team to obtain cardiac clearance and send in prescriptions necessary to procedure.
• Obtain Benefits at time of consultation, follow up consultation and first appointment of the radiation process, Immunotherapy, Radiopharmaceutical therapy.
• Determines and inputs appropriate ICD-9 and ICD-10 diagnosis codes into ARIA for all radiation therapy procedures, which includes treatment, clinic, and physics' procedures.
• Analyze radiation therapy patient records and validate that all charges are captured and correspond with physician orders, prescription, and documentation.
• Review and Export charges within 24 hours of receipt.
• Independently research all coding problems, using all resources prior to seeking help from the Accounts Receivable -Radiation Oncology
• Review all posted charges from Athena for ACFRO within 48 hours of receipt.
• Review radiation therapy work queues, confirming charges interfaced with appropriate ICD-10 and CPT codes.
• Update ARIA/Allscripts patient record with appropriate ICD-10 code as needed.
• Team Alignment- Participates in Striving for Excellence work at the department level.
• Actively contributes to all departmental activities that support a positive work environment.
• Continually communicate with manager and Lead with information regarding non-compliance charges prior to exporting.
• Continually updates data in ARIA and Allscripts accurate demographic information.
• Completes all projects assigned by the manager and physicians in a timely and accurate manner such as but not limited to: Charts audit and fee Schedule
• Provide an analytic end of the month charge audit report such as but not limited to un-reviewed/un-exported, monthly images analysis report.
• Receive a monthly missing encounter report from ACFRO site manager to review his corrections and discrepancies between Varian and Allscripts
• Participate in Weekly AR calls to assist in billing questions that applies to ACFRO.
• Acts as a liaison between Urology Austin and third-party biller to facilitate the gathering of information that will ensure proper response to claim denials.
• Acts as a liaison between Urology Austin and Vendors specific to Immunotherapy drugs and services
• Acts as a liaison between Urology Austin and VA community care
• Point of Contact for the VA HSRM system
• Assist with Quickcode implementation.
• Communicate with various departments on finding statuses of authorizations on behalf of the physicians when requested.
• Participate in Meetings with ACFRO site manager and vendors to better help ACFRO practice and processes.
• Assist Accounts Receivable on claims that have been rejected after first level.
• Assist Accounts Receivable follow up on high dollar unpaid claims in a timely manner. Maintain computer office notes for clear audit trail on every account worked.
• Work delinquent reports after all correspondence is updated.
• Update patient insurance information to guarantee correct insurance billing.
• Provide customer service to patients inquiring about their patient account statements.
• Effectively communicate with patients and insurance companies regarding sensitive financial matters.
• Send via mail or fax: invoices, medical reports, and patient notes to insurance companies to collect payments.
• Print aging/delinquent reports; review work accounts.
• Assist with answering phones with collecting payments, setting up payment plans if needed, explaining radiation processes and billing processes that comes along with Radiation Therapy, Immunotherapy, and Radiopharmaceutical therapy.
• Assist patients with finding foundations for following but not limited to travel, money grants. Etc for cancer related therapies.
• Assist patients with filling out their portion of FMLA, Disability and Cancer Policies.
• Assist with other duties assigned  as needed

• Experience in a large and dynamic organization, especially with business and financial aspects, roles, organizational charts, delegation, and workflows. 
• Knowledge of health care field; medical practice clinical and administrative systems, clinical research field, and sponsor requirements for successful clinical trial completion.
• Understanding of medical and research terminology. 

• Excellence in computer and software systems both in the use and in the evaluation, selection, and integration of these systems.
• Interpersonal and communication both with internal staff and external customers.
• Skill in evaluating and implementing study protocols and budgets.
• Basic skill in reading and interpretation of medical terminology.
• Excellent organizational and time management skills.
• Outstanding verbal and written communication skills.

• Ability to communicate effectively with patients, staff, and external contacts via phone, in person, and through electronic mail.
• Elicit appropriate information for patients to clinic staff.
• Ability to read and understand information and ideas presented in writing.
• Ability to apply general rules to specific problems to produce answers that make sense – deductive reasoning.

• Physical demands: Involves sitting approximately 70-90 percent of the day, walking or standing for the remainder. Work may require stooping and bending, mobility to complete patient study visits, and lifting up to 40 pounds.  
• Work environment: Remote office setting, with time in the clinical setting for patient financial education.