Revenue Cycle Financial Specialist

University of Chicago•Chicago, IL

6d•Remote

About The Position

Be a part of a world-class academic healthcare system, UChicago Medicine, as a Revenue Cycle Financial Specialist with the Revenue Cycle - Patient Access Services Department. This is a remote, work from home opportunity. In this role, the Revenue Cycle Financial Specialist will be responsible for collecting and verifying demographic, guarantor, and insurance information, and educating patients, physicians, and staff on the financial process. The role is responsible for ensuring that preauthorizations/referrals and precertifications are completed in accordance with payor requirements and prior to the scheduled encounter. This position will work closely with staff in clinical areas to acquire necessary clinical information for the authorization process, manage the process of aiding patients and their representatives with securing reimbursement for Hospital and Physician services, and assist patients in identifying and selecting an available option for insurance coverage and/or financial assistance. The specialist will work collaboratively with patients, UCM “coverage vendors”, clinical staff, Patient Financial Services, Ambulatory Patient Financial Specialists, urban health collaborative, and case management/social work. This role will manage all patient account types (outpatient, inpatient, ED, and UCPG) and maintain a thorough knowledge of the hospital’s revenue cycle process. The specialist will understand the Hospitals Inpatient/Outpatient treatment policies and how they relate to each patient’s situation. This role has the responsibility of coordinating and monitoring the flow of revenue generated by UCMC and UCPG. The position involves extensive utilization of the Hospitals revenue systems and constant interaction with patients, physicians, insurance companies, donors, and other members of the Hospitals' staff.

Requirements

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

Responsibilities

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