Revenue Cycle Financial Specialist

Role Description

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, and you may be based outside of the greater Chicagoland area.

In this role, the Revenue Cycle Financial Specialist will be responsible for:

• Collecting and verifying demographic, guarantor, and insurance information.
• Educating patients, physicians, staff, etc. on the financial process.
• Ensuring that preauthorizations/referrals and precertifications are completed in accordance with payor requirements prior to the scheduled encounter.
• Working closely with clinical staff to acquire necessary clinical information for 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.
• Collaborating with patients, UCM “coverage vendors,” 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, while maintaining thorough knowledge of the hospital’s revenue cycle process.
• Understanding the hospital's inpatient/outpatient treatment policies and their relation to each patient’s situation.
• Coordinating and monitoring the flow of revenue generated by UCMC and UCPG.
• Utilizing the hospital's revenue systems and interacting with patients, physicians, insurance companies, donors, and other staff members.

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.
• Ability to pay close attention to a variety of details.
• Must be able to multitask and function in a constantly changing environment.
• Ability to problem solve independently and be strongly invested in team management.
• Knowledge of accounting principles with excellent verbal, math, and presentation skills.

Requirements

• Perform all registration functions: interview patients via telephone or face to face to collect demographic, guarantor, insurance, and financial data required.
• Verify benefits and coverage for scheduled services.
• Prioritize work based on appointment date to ensure completion prior to patient arrival.
• Obtain referrals/authorizations or precertifications to ensure reimbursement of services rendered.
• Document necessary authorization information for clean billing and payment.
• Recognize patients in need of financial assistance and provide charity applications or referrals to the Department of Human Services.
• Interview patients to assist in managing resolution of multiple visit accounts and comply with hospital financial resolution policies.
• Advise and counsel patients and guarantors regarding rights, responsibilities, and procedures related to payment for hospital and ProFee care.
• Act as an advocate to ensure positive guest relations for resolution of inquiries.
• Utilize available resources to identify appropriate financial resolutions for patients and UCM.
• Remain current on regulations that may change the structure and management of the Affordable Health Care Act or Fair Patient Billing Act guidelines.
• Assist patients with financial assistance applications and ensure timely routing to the appropriate department.
• Work closely with patients and UCM MA-NG vendor to assist in Medicaid application completion.
• Assist patients in understanding Health Insurance Exchange plans and support contacting UCM MA-NG vendor.
• Collect 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 requiring administrative intervention or review.
• Meet daily productivity and quality expectations and participate in departmental audit/review processes.

Benefits

• Full Time (1.0 FTE) position.
• Shift: Days Monday-Friday 8am-4:30pm.
• Flexible Remote/Burr Ridge, IL work location.