Patient Financial Navigator, Full Time - Days

University of Chicago Medicine•Burr Ridge, IL

5d•Remote

About The Position

Be a part of a world-class academic healthcare system , UChicago Medicine , as a Patient Financial Navigator with our Patient Access Department. This is a remote, work from home opportunity and you may be based outside of the greater Chicagoland area. The Patient Financial Navigator serves as an integral liaison and primary communicator within the patient’s financial management team. Essential Job Functions Determines & verifies benefits specific to service to be provided; calculates and provides estimates to commercially insured patients including their financial responsibility based on total estimated charges and the patient’s insurance benefits according to departmental procedures if coverage is less than 100% prior to their services &/or as requested; Educates and communicates clearly, via phone and/or follow-up letter, insurance limitations and patient financial responsibilities to patients and/or guarantors. Collects monies from patients with financial responsibilities; including pre-service payments, copays, deductibles, coinsurance & outstanding account receivables as well as establishes payment plans/arrangements for customers as necessary; refers patients to financial counseling as necessary. Screen patients for ability to pay vs inability to pay financial responsibilities; coordinates efforts to determine and educate patients of their financial responsibilities, coverage exclusions, and allowed amounts; oversees the proper application of collected payments to appropriate hospital accounts; works to improve patient healthcare financial literacy. Adheres to and upholds UCM PRIDE values; performs all tasks with excellence in communication, commitment & follows through w/others & tasks, demonstrates respect of one another & ability to adjust to customer needs, upholds privacy & maintains confidentiality of customer information and appropriate professional environment; Meets productivity and quality expectations and participates openly in departmental audit/review process to ensure that all work is monitored and completed based on departmental standards; maintains routine reporting for POS Collections, Estimates & other KPIs. Identifies emerging trends in and current knowledge of payer requirements and exclusions via email communication, memorandums, educational matrices, and in-services; communicates and collaborates to solve issues with revenue leakage. Escalates issues which, per the Financial Eligibility Policy, will require administrative intervention or review and follows up as necessary. Ensures regulatory compliance, i.e., pricing transparency, 501r, patient friendly billing. Performs other duties as assigned.

Requirements

Associates’ degree in business, healthcare, or related field and/or at least 3 years of Revenue Cycle experience with working knowledge of insurance and benefits
Must have working knowledge of accounting with attention to detail, ability to accurately calculate currency
High degree of initiative and problem-solving ability
Must be able to prioritize and execute multiple tasks, with accuracy, in a high-pressure environment
Must be able to demonstrate and maintain a strong customer service orientation and a commitment to excellence in a changing environment
Excellent communication skills and the ability to interact with people in a variety of contexts.
Must respect patient confidentiality and interact with patients, families and other customers with courtesy, tact, and discretion.
Must be strongly invested in a team oriented dynamic environment and possess ability work independently, and make decisions in the best interest of the patient and the Hospitals
Ability and willingness to cooperate with co-workers, supervisors, and physicians to do whatever needs to be done to serve the patient.
Possess the flexibility to learn and incorporate new systems and processes as technology advances

Nice To Haves

Knowledgeable in medical terminology – holding a certificate is a plus
Knowledgeable in diagnostic and CPT coding and guidelines
Knowledge and use of Epic
Knowledgeable in Microsoft Office applications

Responsibilities

Determines & verifies benefits specific to service to be provided
Calculates and provides estimates to commercially insured patients including their financial responsibility based on total estimated charges and the patient’s insurance benefits according to departmental procedures if coverage is less than 100% prior to their services &/or as requested
Educates and communicates clearly, via phone and/or follow-up letter, insurance limitations and patient financial responsibilities to patients and/or guarantors.
Collects monies from patients with financial responsibilities; including pre-service payments, copays, deductibles, coinsurance & outstanding account receivables as well as establishes payment plans/arrangements for customers as necessary; refers patients to financial counseling as necessary.
Screen patients for ability to pay vs inability to pay financial responsibilities
Coordinates efforts to determine and educate patients of their financial responsibilities, coverage exclusions, and allowed amounts
Oversees the proper application of collected payments to appropriate hospital accounts
Works to improve patient healthcare financial literacy
Adheres to and upholds UCM PRIDE values
Performs all tasks with excellence in communication, commitment & follows through w/others & tasks, demonstrates respect of one another & ability to adjust to customer needs, upholds privacy & maintains confidentiality of customer information and appropriate professional environment
Meets productivity and quality expectations and participates openly in departmental audit/review process to ensure that all work is monitored and completed based on departmental standards
Maintains routine reporting for POS Collections, Estimates & other KPIs
Identifies emerging trends in and current knowledge of payer requirements and exclusions via email communication, memorandums, educational matrices, and in-services
Communicates and collaborates to solve issues with revenue leakage
Escalates issues which, per the Financial Eligibility Policy, will require administrative intervention or review and follows up as necessary
Ensures regulatory compliance, i.e., pricing transparency, 501r, patient friendly billing
Performs other duties as assigned