Revenue Cycle Financial Representative

Revenue Cycle Financial Representative

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Summary: Responsible for performing a variety of complex pre-services, financial counseling and customer service related functions for patients and/or their representative including pre-service estimates, collection of pre-payments, collection of prior debt, obtaining authorizations, addressing billing questions, establishing payment plans, screening for financial assistance, responding to MyUNCChart inquiries and other Customer Service requests for both hospital and physician services.

Responsibilities:

• Create Hospital and Physician estimates using the Epic Patient Estimator, review eligibility and benefits utilizing RTE, and obtain authorization requirements.
• Contact patient pre-service providing benefit and patient liability education, explain the estimate cost, and attempt to secure payment and/or set expectation of payment at time of service.
• Provide estimates to patient shoppers and clinical areas across the healthcare system. Work with clinical areas to create estimate templates, determine workflow and process, and collaborate with ISD for template creation and rollout. Provide payment plans for point-of-service (POS) collections.
• Train clinical areas on estimate usage and patient scripting for collections, audit and provide feedback on accuracy of estimates utilizing Epic estimate reports. Track and trend collection amounts and template accuracy utilizing hospital and physician EOBs and refine process to enhance accuracy. Screen and assist patients with financial assistance, Medicaid eligibility and/or other funding sources available.
• Monitor and track routine follow up with Medicaid and financial assistance approvals. Handles HB/PB patient inquiries to address any/all billing questions via inbound calls, MyUNCChart, patient correspondence and patient walk-ins.
• Fulfills patient requests for itemization of charges, adding/verifying/billing insurance, establishing payment plans, payroll deductions, process adjustments, request refunds, and explain charity care policy and guidelines.
• Initiate patient outreach on delinquent payment plans, adding accounts to existing payment plans and high risk/balance accounts. Investigate HB and PB Set off Debt Collection Act (SODCA) disputed accounts that have received a NC State Income Tax refund withhold using current and legacy billing and imaging systems. Meets with attorneys to record depositions, collaborate with the attorney general's office and attend/participate in hearings when needed.
• Work with Patient Relations, Risk Management for HB and PB patients who have escalated complaints or concerns. Oversee HB Client account billing and follow-up which includes validating charges and fee schedules, review and move charges, research and reconcile payments, communicate with multiple departments to answer client questions and collect payments. Work with external customers such as collection agencies, clinics to address any patient concerns

Other information: Education Requirements: High school diploma or GED. Licensure/Certification Requirements: No licensure or certification required. Professional Experience Requirements: Two (2) years of experience in Hospital or Physician Insurance related activities or Call Center Customer Service experience. (Authorization, Billing, Follow-Up, Call-Center, or Collections). Knowledge/Skills/and Abilities Requirements: Excellent interpersonal, verbal and written communication skills. Excellent listening skills, and organizational skills. Advanced knowledge of UB-04, HCFA-1500's and Explanation of Benefits (EOB) interpretation. Intermediate knowledge of CPT and ICD-9 codes. Advanced knowledge of insurance billing, collections and insurance terminology. Ability to work in fast pace environment and prioritize and manage multiple tasks. Healthcare terminology. Customer Service skills. Computer knowledge: MS Word, Excel, and Outlook. Knowledge of 3rd party reimbursements from insurance companies and government payers is a plus.