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Revenue Cycle Financial Specialist, Full Time - Days

Role overview

Qualifications

  • Two (2) years’ experience in medical insurance verification and other hospital finance areas
  • Windows based PC experience
  • High degree of initiative and problem solving ability
  • Strong analytic and financial assessment abilities

Responsibilities

  • Collect and verify demographic, guarantor and insurance information
  • Ensure preauthorization/referrals and precertifications are completed according to payor requirements
  • Assist patients in securing reimbursement for Hospital and Physician services
  • Manage all patient account types and maintain knowledge of the hospital's revenue cycle process

Key facts

Hard skills

Other skills

  • Problem Solving
  • Detail Oriented
  • Multitasking
  • Team Management
  • Analytical Skills
  • Communication
  • Customer Service

About the company

UChicago Medicine logo

UChicago Medicine

The University of Chicago Medicine has been at the forefront of medicine since 1927, when we cared for our first patients. Our mission is to provide superior health care in a compassionate manner, ever mindful of each patient's dignity and individuality. To accomplish our mission, we call upon the skills and expertise of all who work together to advance medical innovation, serve the health needs of the community, and further the knowledge of those dedicated to caring. As one of the nation’s leading academic medical institutions, UChicago Medicine comprises the Medical Center, Pritzker School of Medicine and the Biological Sciences Division. Its main Hyde Park campus is home to the Center for Care and Discovery, Bernard Mitchell Hospital, Comer Children’s Hospital and the Duchossois Center for Advanced Medicine. It also has a 108,000-square-foot facility in Orland Park as well as an outpatient clinic in Chicago's South Loop, as well as affiliations and partnerships that create a regional network of doctors in dozens of Chicago-area communities. UChicago Medicine offers a full range of specialty-care services for adults and children through more than 40 institutes and centers including an NCI-designated Comprehensive Cancer Center. It has 805 licensed beds, nearly 850 attending physicians, about 2,500 nurses and over 1,100 residents and fellows. Harvey-based Ingalls Health joined UChicago Medicine’s network in 2016.

Company details

Company size5001 - 10000

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Job description

Be a part of a world-class academic healthcare system, UChicago Medicine, as a Revenue Cycle Financial Specialist with the Revenue Cycle Department. This is a remote, work from home opportunity and you may be based outside of the greater Chicagoland area.

In this role Revenue Cycle Financial Specialist will be responsible for collecting and verifying demographic, guarantor and insurance information, educate patients, physicians, staff, etc. on the financial process.

  • Responsible for ensuring that preauthorization’s/referrals and precertification’s are in completed in accordance with payor requirements and prior to the scheduled encounter.
  • Work closely with the staff in the clinical areas to acquire necessary clinical information needed to complete authorization process
  • Manage the process of aiding patients and their representatives with securing reimbursement for Hospital and Physician services provided
  • Assist patients in identifying and selecting an available option for insurance coverage and/or financial assistance.
  • Work 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
  • Manage all patient account types; outpatient, inpatient, ED and UCPG, and maintain a thorough knowledge of the hospitals revenue cycle process
  • Understand the Hospitals Inpatient/Outpatient treatment policies and how they relate to each patient situation Have the responsibility of coordinating and monitoring the flow of revenue generated not only by UCMC but UCPG
  • You will be involved in extensive utilization of the Hospitals revenue systems and constant interaction with patients, physicians, insurance companies, donors and other members of the Hospitals' staff 

Essential Functions

  • 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 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 

Required Qualifications

  • 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 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 

Preferred Qualifications

  • Bachelor’s degree

Position Details:

  • Job Type/FTE: Full Time (1.0 FTE)
  • Shift: Days
  • Unit/Department: Revenue Cycle - Patient Access Services 
  • Work Location: Flexible Remote/ Burr Ridge, IL (Must be able to commit to training onsite) 
  • CBA Code: 743 Clerical

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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