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Health Care Reimbursement Analyst I

3 months ago

Chicago, Illinois, United States University of Illinois Chicago Full time


Health Care Reimbursement Analyst I

Health Care Reimbursement Analyst I

Hiring Department
: Health Social Work

Hiring Unit:
University of Illinois Hospital & Health Sciences System (UI Health)

Location
: Chicago, IL USA

Requisition ID
:

Posting Close Date
: 8/2/2024

Position Number
: CF2759,CF2760

About the University of Illinois Hospital & Health Sciences System (UI Health)

The University of Illinois Hospital & Health Sciences System (UI Health) provides comprehensive care, education, and research to the people of Illinois and beyond. A part of the University of Illinois at Chicago (UIC), UI Health comprises a clinical enterprise that includes a 495-bed tertiary care hospital, 22 outpatient clinics, and 13 Mile Square Health Center facilities, which are Federally Qualified Health Centers. It also includes the seven UIC health science colleges: the College of Applied Health Sciences; the College of Dentistry; the School of Public Health; the Jane Addams College of Social Work; and the Colleges of Medicine, Pharmacy, and Nursing, including regional campuses in Peoria, Quad Cities, Rockford, Springfield, and Urbana. UI Health is dedicated to the pursuit of health equity.

This is a full-time and benefits eligible position. UIC offers competitive salaries commensurate with experience. In addition all full time benefits eligible positions include a comprehensive benefits package which include; Health, Dental, Vision, Life, Disability & AD&D insurance, a defined benefit pension plan as well as paid leave which includes; Vacation, Holiday and Sick. In addition we offer tuition waivers for employees and dependents. Click for a complete list of Employee Benefits

UI Health is seeking two Healthcare Reimbursement Analyst I staff to join our Health Social Work team. This role will provide case management services to patients of the University of Illinois Medical Center at Chicago and provide tangible service, case management, and community agency linkage. They will assist in the preparation, maintenance and monitoring of reimbursement initiatives, act as the primary contact for all financial clearance prior to services being rendered. This includes but is not limited to accurate registration including demographics, next of kin, obtain benefits and authorization if necessary prior to patient arrival; work within the University of Illinois Hospital charity policy for uninsured patients; assist clinical staff as necessary with plan of treatment as It relates to patient Insurance plans to insure accurate billing and Increase revenue collection. This position researches additional funding options and collaborates with industry peers to provide current information.

Duties & Responsibilities:
  • Provide case management services to patients/families.
  • Interview patient to obtain demographic and social data as related to financial status, income, and access to community and/or medication resources.
  • Provide general information regarding community and other government agencies. In addition, facilitate applications for programs including, but not limited to, Medicare, Medicaid (Public Aid), Circuit Breaker, Senior Care, and Ryan White.
  • Screen patients/families in consultation/supervision with MSW Supervisor regarding patient/family ability to use community services.
  • Teach patient/families how to work efficiently with community and UICMC systems.
  • Develop and present educational seminars for staff and DHSW staff regarding available community resources.
  • Provide assistance with IDPA 2636, Allkids, MANG/disability, Emergent Need, SA Vouchers, CVC applications, ABE, SNAP or any financial entitlement program to patient/families when deemed necessary.
  • Provide assistance and completion of Birth Certificates and the processing of all forms and submission to the State of Illinois.
  • Follow up with patients to determine status of coverage through state and Federal entitlements and manufacturer programs.
  • Provide exploration and updating of community resources and procedures, and the dissemination of this information to the Health Social Work Staff.
  • Updating eligibility for community resources.
  • Exploring services of new community agencies (i.e., target population, eligibility for services, patient cost, length of services, etc.)
  • Establishing and maintaining a resource file which would be available to other departmental staff.
  • As assigned, participates in social work and patient account meetings.
  • Assists in the analysis and interpretation of rules and regulations as they apply to the health care facility and ensures the data is in the format required for reporting purpose.
  • Complies and keeps up to date the Commerce Clearing House on Medicare and Medicaid, CAC, ABE guides and ensures that staff and management are kept abreast of new developments.
  • Assists in the examination and analysis of new regulations to determine the financial impact on the health care facility.
  • Participate in the departmental Continuous Quality Improvement program.
  • Document clinic outcome data and assist in preparing program activity reports.
  • Assists in assembling data as required during audits.
  • Function as a clerical support person to other Health Social Work Staff as needed.
  • Upgrades to all appropriate encounters for patients whom applications are were (Self Pay to Approved Insurance).
  • Generate unofficial bills for purpose of Financial applications or when SW/UM staff request to submit on a letter of financial responsibility.
  • Process Community Discount upon request with collaboration from Patient Accounts.
  • Assist with Redetermination applications.
  • Maintain appropriate and required records, such as documentation in EMR and monthly departmental statistics.
  • Using a knowledge of Medicare and Medicaid government regulations, completes statistical and financial modeling to produce cost reports to ensure all possible reimbursement enhancements or opportunities are captured
  • Completes analysis of new developments and/or proposals in the reimbursement field to determine the financial impact on the health care facility
  • Gathers data and completes required analysis at the request of outside audit staff during audits by Medicare, Medicaid, and Blue Cross and reports the impact of audit adjustments to management
  • Assists management in the analysis and development of third party contractual allowances, using financial and statistical modeling
  • Assists management in the analysis and development of bad debt projections, using financial modeling, for budget forecasting
  • Assists more senior staff members in the review of existing operating procedures and makes recommendations for the development of settlement data to maximize reimbursement from third party payers
  • Recommends improvements and modifications to departmental operating procedures to maximize operating efficiency and reimbursement
  • Completes review and analysis of prior years' outstanding cost reports to resolve outstanding issues in conformance with regulations and within the time frame imposed by the federal government's statute of limitations
  • Provides assistance, by reviewing current and prior years' data and other necessary variance explanations, in coordinating the annual financial audit of the health care facility by outside audit firms.
  • Attends Revenue or Financial Entitlement Committee meetings, conferences, Insurance verification webinar/seminars as instructed and other planning/organizational meetings as requested.
  • Participates in quality improvement initiatives and assists the Director in collecting data.
Minimum Qualifications Required:

  1. Any one or combination totaling three (3) years (36 months) from the categories below:
    A. Bachelor's degree with a major in accounting, business administration, management, or finance.

    B. Progressively more responsible work experience that provided a knowledge of generally accepted principles, theories, and practices in healthcare/medical billing.
  2. One (1) year (12 months) of professional experience in third-party reimbursement for health care facilities (such as an accountant or auditor).
Preferred Qualifications:
  • Bilingual language skills with the ability to read, write, speak and translate Spanish/English
To Apply:
For fullest consideration click on the
Apply Now button
, please fully complete all sections of the online application including adding your full work history with specific details of your duties & responsibilities for each position held. Fully complete the education, licensure, certification and language sections. You may upload a resume, cover letter, certifications, licensures, transcripts and diplomas within the application.

Please note that once you have submitted your application you will not be able to make any changes. In order to revise your application you must withdraw and reapply. You will not be able to reapply after the posting close date. Please ensure the application is fully completed and all supporting documents have been uploaded before the posting close date. Illinois Residency is required within 180 days of employment

The University of Illinois System is an equal opportunity employer, including but not limited to disability and/or veteran status, and complies with all applicable state and federal employment mandates. Please visit Required Employment Notices and Posters to view our non-discrimination statement and find additional information about required background checks, sexual harassment/misconduct disclosures, and employment eligibility review through E-Verify.

The university provides accommodations to applicants and employees. Request an Accommodation

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The University of Illinois System is an equal opportunity employer, including but not limited to disability and/or veteran status, and complies with all applicable state and federal employment mandates. Please visit Required Employment Notices and Posters to view our non-discrimination statement and find additional information about required background checks, sexual harassment/misconduct disclosures, and employment eligibility review through E-Verify.

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