Revenue Cycle Financial Specialist, Full Time - Days

Summary

UChicago Medicine is a world-class academic healthcare system. The Revenue Cycle Financial Specialist collects and verifies patient demographic, guarantor, insurance, and financial information; manages authorizations, reimbursement, financial assistance, and patient account resolution; and collaborates with patients, clinical staff, vendors, and insurance providers in a remote revenue cycle role.

Responsibilities

• Responsible for ensuring that preauthorization’s/referrals and precertification’s are in completed in accordance with payor requirements and prior to the scheduled encounter
• Work closely with the staff in the clinical areas to acquire necessary clinical information needed to complete authorization process
• Manage the process of aiding patients and their representatives with securing reimbursement for Hospital and Physician services provided
• Assist patients in identifying and selecting an available option for insurance coverage and/or financial assistance
• Work collaboratively with patients, UCM “coverage vendors” – currently GLM, clinical staff, Patient Financial Services, Ambulatory Patient Financial Specialists, urban health collaborative and case management/social work
• Manage all patient account types; outpatient, inpatient, ED and UCPG, and maintain a thorough knowledge of the hospital’s revenue cycle process
• Understand the Hospitals Inpatient/Outpatient treatment policies and how they relate to each patient’s situation Have the responsibility of coordinating and monitoring the flow of revenue generated not only by UCMC but UCPG
• You will be involved in extensive utilization of the Hospitals revenue systems and constant interaction with patients, physicians, insurance companies, donors and other members of the Hospitals' staff
• Perform all registration functions: interview patients via telephone or face to face to collect demographic, guarantor, insurance and financial data required
• Verify the benefits as well as the coverage for services scheduled
• Prioritize work based on appointment date to ensure everything is completed prior to the patient arriving at UCM
• Obtain referrals/authorizations or precertification’s to ensure reimbursement of services rendered Document necessary authorization information in appropriate fields for clean billing and payment
• Recognizes those patients in need of financial assistance, and provides charity applications or referrals to the Department of Human Services
• Interview the patients to be able to assist in managing a resolution of a patient’s multiple visit accounts and be compliant with Hospital financial resolution policies
• Advise and counsel patients and guarantors regarding patient rights, responsibilities and procedures as it relates to payment for Hospital and ProFee care
• Act as an advocate to ensure positive guest relations for resolution of inquiries
• Utilize all available resources to identify the most appropriate financial resolution for both the patients and UCM
• Remain current of any city, county, state or federal regulation(s) that may change the structure and management of the current Affordable Health Care Act or Fair Patient Billing Act guidelines
• Assists patients with financial assistance applications
• Ensure completed Financial Assistance applications get routed to the appropriate department for consideration in a timely manner
• Work closely with both the patient and UCM MA-NG vendor to assist in the completion of the Medicaid application. This will ensure that the Medicaid applications are completed in a timely manner
• Assist the patient in understanding the Health Insurance Exchange plans potentially available to them, and support the patient in contacting the UCM MA-NG vendor to start the process
• Collect any necessary payments due prior to services being rendered using PPE system through PASSPORT
• Investigate and resolve charge disputes, process patient refunds, identify adjustments required to accounts and make corrections. Make payment arrangements on past due balances
• Escalate issues that per Treatment Policy that require administrative intervention or review
• Meet daily productivity and quality expectations and participate openly in departmental audit/review process to ensure that all work is monitored and completed based on departmental standards
• Other Duties Assigned

Skills

• Two (2) years' experience in medical insurance verification and other hospital finance areas (including Hospital Billing)
• Windows based PC experience
• High degree of initiative and problem-solving ability
• Strong analytic and financial assessment abilities as well as the ability to pay close attention to a variety of details are required to perform duties effectively
• Must be able to multitask and be able to function in a constantly changing environment
• Requires the ability to problem solve independently and must be strongly invested in team management
• Must have knowledge of accounting principles with excellent verbal, math and presentation skills
• Bachelor's degree

Qualifications

Must Haves

• Two (2) years' experience in medical insurance verification and other hospital finance areas (including Hospital Billing)
• Windows based PC experience
• High degree of initiative and problem-solving ability
• Strong analytic and financial assessment abilities as well as the ability to pay close attention to a variety of details are required to perform duties effectively
• Must be able to multitask and be able to function in a constantly changing environment
• Requires the ability to problem solve independently and must be strongly invested in team management
• Must have knowledge of accounting principles with excellent verbal, math and presentation skills

Nice to Haves

• Bachelor's degree

Benefits

• Remote, work-from-home opportunity; employees may be based outside of the greater Chicagoland area, with a commitment to onsite training or required onsite meetings.