RCM Representative Senior, Third-Party Claims- HB

3 months ago

Minneapolis, United States Hennepin County Medical Center Full time

Hennepin Healthcare is an integrated system of care that includes HCMC, a nationally recognized Level I Adult Trauma Center and Level I Pediatric Trauma Center and acute care hospital, as well as a clinic system with primary care clinics located in Minneapolis and across Hennepin County. The comprehensive healthcare system includes a 473-bed academic medical center, a large outpatient Clinic & Specialty Center, and a network of clinics in the North Loop, Whittier, and East Lake Street neighborhoods of Minneapolis, and in the suburban communities of Brooklyn Park, Golden Valley, Richfield, and St. Anthony Village. Hennepin Healthcare has a large psychiatric program, home care, and operates a research institute, philanthropic foundation, and Hennepin EMS. The system is operated by Hennepin Healthcare System, Inc., a subsidiary corporation of Hennepin County.

Equal Employment Opportunities: We believe equity is essential for optimal health outcomes and are committed to achieve optimal health for all by actively eliminating barriers due to racism, poverty, gender identity, and other determinants of health. We are committed to equitable care and working in an environment that celebrates, promotes, and protects diversity, equity, inclusion, and belonging. We are committed to bringing in individuals with new cultural perspectives to assist in creating a more equitable healthcare organization.

SUMMARY:
We are currently seeking an RCM Representative Senior to join our Third-Party Claims- HB & PB team. This full-time role will primarily work remotely (SHIFT: Day).

Purpose of this position: Working under general supervision, provides revenue cycle services to incoming and existing patients and their families either in person or by telephone. Is responsible for gathering patient information needed to provide services such as following up on complex claim issues, financial clearance, customer service, or admission. Works will be assigned via a work queue in the electronic health record system

Current List of non-MN States where Hennepin Healthcare is an Eligible Employer: Alabama, Arizona, Arkansas, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Nevada, North Carolina, North Dakota, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin.

RESPONSIBILITIES:

  • Gathers information from patients, clients/family members, HCMC clinical areas, government agencies, employers, third party payors, and/or medical payment programs, etc. both in-person and by telephone to register patients, gather or update information, obtain referrals and pre-authorizations, complete appropriate forms, conduct evaluations, determine benefits and eligibility (insurance, public programs, etc.), determine financial responsibility, and/or to identify sources of payment for services
  • Requests, inputs, verifies, and modifies patient's demographic, primary care provider, and payor information
  • Utilizes tools, including computer programs, when indicated
  • Makes appropriate referrals (i.e. Patient Financial Care Specialists, Collections Specialists) as appropriate
  • Provides excellent customer service and timely response to questions and issues related to benefits, billing, claims, payments, etc.
  • Answers questions (by phone and in-person) and provides quotes for services (including discounts), identifies financial resources, etc. in accordance with HCMC policies and procedures
  • Utilizes various databases and specialized computer software for financial care activities including eligibility verifications, pre-authorizations, medical necessity, review/updating of patient accounts, etc.
  • Establishes plans (patient liabilities, payment, etc.) and conducts follow up activities related to those plans
  • Inputs, retrieves, and modifies information and data stored in computerized systems and programs; generates reports using computer software
  • Explains charges, answers questions, and communicates a variety of requirements, policies, and procedures regarding patient financial care services and resources to patients, staff, payors, and agencies
  • Works with Claims and Collections (both internally and with collection agencies) in order to assist patients and their families with billing and payment activities in order to increase cash flow
  • Other duties as assigned

QUALIFICATIONS:
Minimum Qualifications:

  • 2 years clerical experience in health care revenue cycle operations: billing/claims, patient accounting, collections, admissions, registration, etc.
  • Bilingual strongly preferred, required in some positions

-OR-

  • An approved equivalent combination of education and experience

Preferred Qualifications:

  • Demonstrated organizational skills and the ability to prioritize and manage tasks based on established criteria
  • Excellent verbal and written communication and interpersonal skills
  • Ability to work independently with minimal supervision, within a team setting and be supportive of team members
  • Proficient with Microsoft Office
  • Ability to analyze issues and make judgments about appropriate steps toward solutions
  • CRCR (Credentialed Revenue Cycle Representative) preferred

Knowledge/ Skills/ Abilities:

  • Knowledge of patient billing claims process
  • Ability to communicate with patients and families under sometimes stressful circumstances
  • Strong telephone communication skills
  • Experience with electronic health record or similar software program
  • Knowledge of payor programs
  • Knowledge of applicable federal and state regulations

You've made the right choice in considering Hennepin Healthcare for your employment. We offer a wealth of opportunities for individuals who want to make an impact in our patients' lives. We are dedicated to providing Equal Employment Opportunities to both current and prospective employees. We are driven to connect talented individuals with life-changing career opportunities, enabling you to provide exceptional care without exception. Thank you for considering Hennepin Healthcare as a future employer.

Please Note: Offers of employment from Hennepin Healthcare are conditional and contingent upon successful clearance of all background checks and pre-employment requirements.

Department: Third-Party Claims - HB & PBPrimary Location: MN-Minneapolis-Downtown Campus Standard Hours/FTE Status: FTE = 1.00 (80 hours per pay period)Shift Detail: DayJob Level: StaffEmployee Status: Regular Eligible for Benefits: YesUnion/Non Union: Union Job Posting: May-31-2024
EEO/Disability/Veteran employer.

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