NWIN Cancer Insurance Specialist

The University of Chicago Medicine•Crown Point, IN

22h•Onsite

About The Position

Join a world-class academic healthcare system, UChicago Medicine Crown Point, located in Crown Point, Indiana, as a Cancer Insurance Specialist. UChicago Medicine is an integrated academic and community health system with multiple primary medical facilities within the surrounding suburbs of Chicago. UChicago Medicine, Crown Point is a new two-story, 130,000-square-foot multispecialty care center and micro-hospital in Northwest Indiana for what will be the academic health system's largest off-site facility and its first freestanding building in Indiana. The Crown Point care center will include: A micro-hospital with an eight-bed emergency department and a short-stay inpatient unit A comprehensive cancer center with infusion therapy as well as radiation, medical and surgical oncology An imaging center with MRI, CT, PET, X-ray and ultrasound capabilities An outpatient surgery center Laboratory services Medical offices with access to UChicago Medicine’s physicians and specialists, including those in cancer care, cardiology, digestive diseases, orthopaedics, neurosciences, pediatrics, primary care, surgical specialties, transplant care and women’s health Job Summary: Responsible for pre-registration, insurance verification and payer authorizations of inpatients and outpatients, and educating patients about their financial responsibilities and resources to assist with same. Works with patient and families and collaborates with members of the clinical and administrative team, including Patient Access and Call Center teams, from the point of initial referral through clinical evaluation, and continuing through active treatment and for follow-up visits. Requires extensive utilization of Hospital revenue systems, and continuous interaction with patients, physicians, insurance companies, and other member of the Hospitals and Biological Science Division staff. Routinely interacts with the insurance companies to ensure proper payments for all cancer-related services, and serves as an advocate for the patient when billing problems occur. The (Cancer) Insurance Specialist advises patients of anticipated costs. Works with health insurance providers to determine coverage, benefit limits, and financial responsibility. Uses the patients’ electronic health record to both access and document information which supports authorization, therefore, ensuring a systematic approach to sharing critical information. Networks with other precertification/insurance employees across UCM’s billing entities to stay abreast of and share recent changes, updates, and processes. Provides complete information to the Single Case Agreement Team on initial request in an effort to facilitate a standardized and systematic process for non-par insurance plans. Maintains and develops clear lines of communication with insurance representatives from multiple insurance companies who can provide precertification/authorization guidelines unique to their company. Must be able to effectively manage work across departments, work independently with minimal supervision, and participate in administrative decisions. Embodies a compassionate and tactful manner. Strong communication skills, attention to detail, problem solving and a high degree of organization are critical qualities

Requirements

Bachelor’s degree, or equivalent, and/or 2 years’ experience working in medical insurance verification and/or other healthcare finance areas.
Minimum of five years related healthcare registration, billing and/or reimbursement experience required.
Advanced insurance authorization and registration techniques required
Ability to schedule and register patients rapidly and accurately.
Strong communication skills and must be able to communicate courteously and effectively with physicians, payers, and staff.
Must be a self-motivated
Individual must be highly organized and dependable, and able to work with minimum of supervision
Registration Essentials
Windows-based PC experience

Nice To Haves

Previous experience in complex clinical setting that required coordination of multiple services
Resource scheduling experience preferred (e.g. ancillary testing)
Background in medical terminology; (Oncology) experience preferred
Website Insurance Training (Navinet, WebMD, Passport)
EPIC training & testing (Prelude/Cadence).

Responsibilities

Collects and verifies demographic information, insurance coverage, plan benefits, and referring physician data for (cancer) patients. Uses all necessary and available electronic systems and tools.
Discusses in-person (preferred), or telephonically, benefits and financial information with all referred (cancer) patients and their families prior to initial evaluation. Provides face-to-face or telephonic financial counseling and information regarding the insurance to patients, families, and related Hospital staff.
Obtains detailed patient insurance benefit information from point of initial referral, including initial consult, diagnostic work-up, hospitalization(s), and follow-up clinic visits.
Collaborates with Social Worker and/or Pharmacy to provide information to patients and their families regarding available financial assistance resources. Assists patients in completing necessary documents to apply for financial assistance, free care, special pharmacy benefits, etc.
Assists patients in answering billing questions and facilitates resolution of issues.
Communicates/Educate family and/or responsible party, as necessary, to inform them of any insurance problems or restrictions, ensuring that insurance information is clearly relayed to and understood by family and/or responsible party.
Completes abbreviated assessment to determine family eligibility for Charity Care programs, for handoff to Revenue Cycle’s approvals team (located offsite in Darien office).
Communicates and coordinates as necessary with Patient Access team to share information and reduce redundancy.
Initiates appropriate handoffs to other insurance specialists and departments, as patient moves from one clinical service, to another, to ensue continuous monitoring of benefits and obligations, while communicating same among colleagues.
Communicates initially with Call Center regarding intake information, and then proactively and directly with the clinical team , regarding status of authorization and the need for clinical documentation
Monitors and updates information regarding insurance data, physicians, authorizations, and preferred providers.
Obtains all necessary payor authorizations for cancer care. Verifies coverage and other medical benefits and acquires necessary referrals and authorizations. Confirms pre- authorizations for procedures. Verifies receipt of and facilitates managed care referrals for office visits. Documents insurance coverage and authorization information in EPIC.
Documents all relevant information into EPIC
Partners with Single Case Agreement Department to facilitate non-par cases to obtain care/treatment
Responds to incoming calls regarding account status from patients and insurance companies
Performs other duties assigned