Revenue Cycle Financial Specialist

Overview

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 position will be primarily a work from home opportunity with the requirement to come onsite as needed. 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.

Essential functions and responsibilities are described in the sections below.

• Responsible for ensuring that preauthorizations/referrals and precertifications are completed in accordance with payor requirements and prior to the scheduled encounter.
• Work closely with staff in the clinical areas to acquire necessary clinical information needed to complete the 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 hospital revenue cycle process.
• Understand the hospital inpatient/outpatient treatment policies and how they relate to each patient situation. Coordinate and monitor the flow of revenue generated not only by UCMC but UCPG.
• Be involved in extensive utilization of the hospital revenue systems and maintain constant interaction with patients, physicians, insurance companies, donors and other members of the hospital staff.

• 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 services scheduled.
• Prioritize work based on appointment date to ensure everything is completed prior to the patient arriving at UCM.
• Obtain referrals/authorizations or precertifications to ensure reimbursement of services rendered. Document necessary authorization information in appropriate fields 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 a patient’s multiple visit accounts and comply 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 Pro Fee 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 regulations that may change the structure and management of the current Affordable Health Care Act or Fair Patient Billing Act guidelines.
• Assist patients with financial assistance applications and ensure completed Financial Assistance applications are 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, ensuring timely completion.
• Assist the patient in understanding 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 require…