Revenue Cycle Representative (Financial Counseling) - Self-Pay, Analytics, Revenue Cycle Counseling (SPARC) - Patient Financial Services

UIOWA•Iowa City, IA

6d•Hybrid

About The Position

University of Iowa Health Care’s department of Patient Financial Services is seeking a Revenue Cycle Representative (RCR)-Financial Counselor for an entry-level financial services position in the healthcare industry and within the department of Patient Financial Services. Team members are divided among our sub-teams (i.e. Pre-Authorization; Patient Billing Services; Financial Counseling; Physician and Hospital A/R Management PHARM}; etc). This opening is within our Financial Counseling Team. The Financial Counselor will be expected to provide exceptional customer service to our external customers: patients, patient families, insurance contacts, etc; as well as internal customers. You will support our “Service Excellence” standards to all our customer groups by demonstrating compassion, empathy, and respecting patient rights. You will utilize tools and processes to make independent decisions and maintain a high level of integrity regarding patient rights. The Financial Counselor must have a demonstrated ability to prioritize, multi-task & quickly change focus in fast-paced team environment. You will be expected to provide accurate and comprehensive information (verbally and in writing) to patients, outside agencies and various administrative and management personnel regarding all third-party interactions, patient billing and customer service activities. This position is primarily a combination of remote and onsite (hybrid) work locations. Remote work must be performed at an offsite location within the State of Iowa. Training will be held either on ONSITE at the HSSB building or via zoom, with location and length of training determined by the supervisor. Remote eligibility will be evaluated upon a satisfactory job training opportunity. Per policy, work arrangements will be reviewed annually and must comply with the remote work program and related policies and employee travel policy when working at a remote location. University of Iowa Health Care—recognized as one of the best hospitals in the United States—is Iowa's only comprehensive academic medical center and a regional referral center. Each day more than 12,000 employees, students, and volunteers work together to provide safe, quality health care and excellent service for our patients. Simply stated, our mission is: Changing Medicine. Changing Lives.® WE CARE Core Values: Welcoming - We have an environment where everyone has a voice that is heard; that promotes the dignity of our patients, trainees, and employees; and allows all to thrive in their health, work, research, and education. Excellence - We achieve and deliver our personal and collective best in the pursuit of quality and accessible health care, education, and research. Collaboration - We collaborate with health care systems, providers, and communities across Iowa and the region as well as within our UI community. We believe teamwork—guided by compassion—is the best way to work. Accountability - We behave ethically, act with fairness and integrity, take responsibility for our own actions and respond when errors in behavior or judgment occur. Respect - We create an environment where every individual feels safe, valued, and respected, supporting the well-being and success of all members of our community. Empowerment - We commit to fair access to research, health care, and education for our community and opportunities for personal and professional growth for our staff and learners.

Requirements

Bachelor’s degree; or equivalent combination of education and experience.
Minimum 6 months revenue cycle, health insurance or related customer/patient focused service experience.
Strong attention to detail and proven ability to gather and analyze data and keep accurate records.
Proficiency with computer software applications, i.e. Microsoft Office Suite (Excel, Word, Outlook, PowerPoint) or comparable programs and an ability to quickly learn and apply new systems knowledge.
Demonstrated ability to remain professional while managing difficult situations with callers, customers or patients and able handle complex and ambiguous situations with minimal supervision.
Self-motivated with initiative to seek out additional responsibilities, tasks and projects.
Excellent, professional verbal and written communication skills to provide outstanding customer service and support a "Service Excellence" environment working with a professional and patient population.
Basic knowledge of medical terminology and working knowledge of HIPAA laws and regulations.

Nice To Haves

Demonstrated ability to maintain or improve established productivity and quality requirements.
Working knowledge healthcare billing and/or Federal and state assistance programs.
Bi-lingual skills in a foreign language highly desired (Spanish and/or French highly preferred).
Experience navigating payor portals and interpreting insurance benefits across a broad range of commercial, government, and managed care plans.
Knowledge and understanding of service types (e.g., primary care, specialty care, outpatient, inpatient, etc.) and how they apply across medical services and insurance benefit structures.
Demonstrated ability to identify opportunities to improve estimate efficiency and accuracy from both system and end-user perspectives.

Responsibilities

Coordinate with clinical department leaders, medical staff and hospital coders to develop treatment plans of care for financially unsecure patients.
Provide assistance in educating department leaders, medical staff and other UI Health Care employees on internal policies, changes, and processes such as UI Health Care’s Patient Access Policy and Pre-Service Charge Adjustment Review Team (CART).
Prepare and submit Pre-Service CART forms as well as facilitate Pre-Service CART process.
Collaborate with Payor Relations on new agreements for underinsured patients.
Verify benefits and provide financial counseling to patients and families to ensure they are advised of their financial obligations, with appropriate financial arrangements made according to the hospitals financial policy.
Use knowledge of Current Procedure Terminology (CPT) to generate self-pay and insured estimates for one-time services and treatment plans via the Epic Estimator. Use attention to detail when verifying benefit information from insurance websites as well as Real Time Eligibility (RTE) queries.
Provide financial counseling via phone and/or in-person based on the patient’s liability and ability to pay.
Advise patients and/or family members about their healthcare accounts, collect appropriate self-pay balances, establish payment arrangements, screen and link patients to the available funding sources such as: Medicaid, COBRA Subsidy program, Immergruen, Healthcare Marketplace, Payment Plans, and external Financing Options
Screen patients, educate and facilitate application process for UI Health Care’s internal financial assistance program prior to receiving care.
Identify and assist patients who are unable to pay their estimated liability or who have existing balances.
Identify & report undesirable trends and reimbursement modeling errors or underlying causes of incorrect payment; review allowed variances from third party payers.
Be expected to maintain a high-level of accuracy to meet productivity and quality requirements.
Identify trends and/or work processes for potential process improvements.
Review and analyze report data to provide status updates to leadership.
Communicate with providers, payers, patients, internal departments, co-workers and Coordinator’s to resolve issues and take appropriate actions.