RCM Specialist

Hennepin Healthcare•Minneapolis, MN

1d•Onsite

About The Position

The Financial Counselor serves as Hennepin Healthcare’s primary contact for patient reimbursement issues, following established credit and Financial Counseling policies. The role provides information about hospital payment requirements, alternative financing, and charity care programs, with communications intended to support positive patient relations and prompt reimbursement. The position also performs related duties as assigned.

Requirements

A two-year degree in Accounting, Business, Healthcare Administration, Health & Human Services, or a related field, or an approved equivalent combination of education and experience.
Two to three years of exposure to payor systems and/or knowledge of public financial resources.
Familiarity with statutes and regulations affecting collection of past-due accounts.
Broad knowledge of government assistance programs, guidelines, and application procedures.
Ability to communicate and respond to inquiries effectively, including explaining payment policies to patients and persuading patients to settle account balances.
Effective interpersonal skills and ability to interact with patients.

Nice To Haves

Bachelor’s degree in Accounting, Business, Healthcare Administration, or a related field.
Understanding of managed health care.
Demonstrated organizational skills and ability to prioritize and manage tasks according to established criteria.
Excellent verbal and written communication and interpersonal skills.
Ability to work independently with minimal supervision, work within a team, and support team members.
Proficiency with Microsoft Office.
Experience using an electronic health record or similar software.
Ability to analyze issues and make judgments about appropriate steps toward solutions.
CRCR (Credentialed Revenue Cycle Representative) certification.
Bilingual Spanish.

Responsibilities

Meet with self-pay and under-insured patients to obtain valid insurance coverage, confirm eligibility when applicable, and review prior accounts to update coverage information.
Notify appropriate departments of coverage information when necessary and enter account notes into the electronic medical record.
Educate, screen, and assist patients without valid insurance coverage with enrollment in Medicaid, other state-based and commercial assistance programs, and financial assistance.
Work with Social Services to resolve financial barriers preventing safe inpatient discharge to the community or another appropriate care facility.
Work with the Hennepin County DHS team to expedite applications that support timely discharge.
Communicate with nursing homes, rehabilitation facilities, and other facilities about pending Medicaid applications to support patient acceptance and timely discharge.
Collect payments before admission or discharge, including outstanding accounts receivable, self-pay down payments, and insured patients’ copays and deductibles.
Work with the Division of Expanded Care to complete forms and applications when a patient needs a State of Minnesota disability determination.
Educate patients during interviews about applicable policies, including point-of-service collections, payment plans, and financial assistance eligibility.
Research, identify, and resolve special circumstances affecting delayed payment of self-pay accounts.
Work with the on-site clinical care team or an outside eligibility vendor to complete Medicaid applications appropriately and maximize funding based on patient eligibility.
Stay informed about statutes and regulations affecting receivables collection, including insurance company changes and collection regulations.
Confer with third parties regarding forms, patient financial information, financial obligations, and hospital credit policy.
Meet and maintain initial and ongoing Minnesota DHS and MnSure requirements and certifications related to the Financial Counselor role.
Complete procedures for filing Medicaid and other public assistance program applications.
Follow up with patients and other entities to obtain outstanding verifications needed to determine eligibility for assistance programs.
Respond promptly, accurately, and professionally to patients and internal and external business partners by phone, email, or mail, as appropriate.
Complete, process, follow up on, and approve or deny financial assistance applications for the organization.