Revenue Cycle Financial Specialist - PFX

UChicago Medicine•Chicago, IL

5d•Remote

About The Position

Join one of the nation’s most comprehensive academic medical centers, UChicago Medicine, as a Revenue Cycle Financial Specialist with the Revenue Cycle - Patient Access Services Department. In this role, the Revenue Cycle Financial Specialist will be responsible for collecting and verifying demographic, guarantor and insurance information, and educating patients, physicians, staff, etc. on the financial process.

Requirements

BA degree or equivalent and/or 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 in order 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.
Excellent communication skills and the ability to deal 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 have the ability to prioritize daily tasks, 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 in order to serve the patient.
Possess the flexibility to learn and incorporate new systems and processes as technology advances.
Demonstration of both a strong customer service orientation and a commitment to excellence.
Maintain accuracy with working in a fast-paced, multi-task environment.

Nice To Haves

Experience in patient advocacy preferred
Knowledge and use of Epic, GE and Centricity strongly preferred.

Responsibilities

Ensuring that preauthorization’s/referrals and precertification’s are completed in accordance with payor requirements and prior to the scheduled encounter.
Working closely with staff in clinical areas to acquire necessary clinical information needed to complete the authorization process.
Managing the process of aiding patients and their representatives with securing reimbursement for Hospital and Physician services provided.
Assisting patients in identifying and selecting an available option for insurance coverage and/or financial assistance.
Working 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.
Managing all patient account types; outpatient, inpatient, ED and UCPG, and maintaining a thorough knowledge of the hospitals revenue cycle process.
Understanding the Hospitals Inpatient/Outpatient treatment policies and how they relate to each patient situation.
Coordinating and monitoring the flow of revenue generated not only by UCMC but UCPG.
Performing all registration functions: interviewing patients via telephone or face to face to collect demographic, guarantor, insurance and financial data required.
Verifying the benefits as well as the coverage for services scheduled.
Prioritizing work based on appointment date to ensure everything is completed prior to the patient arriving at UCM.
Obtaining referrals/authorizations or precertification’s to ensure reimbursement of services rendered.
Documenting necessary authorization information in appropriate fields for clean billing and payment.
Recognizing patients in need of financial assistance, and providing charity applications or referrals to the Department of Human Services.
Interviewing patients to assist in managing a resolution of a patient’s multiple visit accounts and being compliant with Hospital financial resolution policies.
Advising and counseling patients and guarantors regarding patient rights, responsibilities and procedures as it relates to payment for Hospital and ProFee care.
Acting as an advocate to ensure positive guest relations for resolution of inquiries.
Utilizing all available resources to identify the most appropriate financial resolution for both the patients and UCM.
Remaining current on 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.
Assisting patients with financial assistance applications.
Ensuring completed Financial Assistance applications get routed to the appropriate department for consideration in a timely manner.
Working closely with both the patient and UCM MA-NG vendor to assist in the completion of the Medicaid application.
Assisting the patient in understanding the Health Insurance Exchange plans potentially available to them, and supporting the patient in contacting the UCM MA-NG vendor to start the process.
Collecting any necessary payments due prior to services being rendered using PPE system through PASSPORT.
Investigating and resolving charge disputes, processing patient refunds, identifying adjustments required to accounts and making corrections.
Making payment arrangements on past due balances.
Escalating issues that per Treatment Policy require administrative intervention or review.
Meeting daily productivity and quality expectations and participating openly in departmental audit/review process to ensure that all work is monitored and completed based on departmental standards.
Other Duties Assigned