RCM Representative Senior, Third-Party Claims- HB
4 weeks ago
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 on-site (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
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 = hours per pay period)Shift Detail: DayJob Level: StaffEmployee Status: Regular Eligible for Benefits: YesUnion/Non Union: Union Job Posting: MayEEO/Disability/Veteran employer.
-
RCM Representative Sr, Third-Party Claims
1 week ago
Minneapolis, Minnesota, United States Hennepin County Medical Center Full timeHennepin 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...
-
RCM Representative Sr, Third-Party Claims
4 weeks ago
Minneapolis, Minnesota, United States Hennepin County Medical Center Full timeHennepin 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...
-
Minneapolis, Minnesota, United States Hennepin County Medical Center Full timeHennepin 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...
-
Minneapolis, Minnesota, United States Hennepin County Medical Center Full timeHennepin 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...
-
Minneapolis, Minnesota, United States Hennepin County Medical Center Full timeHennepin 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...
-
Minneapolis, Minnesota, United States Hennepin County Medical Center Full timeHennepin 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...
-
RCM Representative, Admitting and Registration
4 weeks ago
Minneapolis, Minnesota, United States Hennepin County Medical Center Full timeHennepin 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...
-
RCM Representative, Admitting and Registration
4 weeks ago
Minneapolis, Minnesota, United States Hennepin County Medical Center Full timeHennepin 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...
-
RCM Representative, Admitting and Registration
3 months ago
Minneapolis, Minnesota, United States Hennepin County Medical Center Full timeHennepin 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...
-
RCM Representative, Admitting and Registration
1 month ago
Minneapolis, Minnesota, United States Hennepin County Medical Center Full timeHennepin 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...
-
Senior Claims Examiner
3 days ago
Minneapolis, Minnesota, United States Crawford & Company Full timeSenior Claims Examiner - Workers CompensationRequisition ID Job LocationsUS-MN-Minneapolis | USPosition TypeRegular Full-TimeCategoryClaimsBusiness UnitBUS_TPA USExcellence In Everything We TouchPosition SummaryInvestigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision. Works within established authority on...
-
Claim Examiner- WC
1 week ago
Minneapolis, Minnesota, United States Hornet Staffing Full timeDescription: Receives claim assignment, confirms policy coverages and directs acknowledgement of claims. Interprets and makes decisions using independent judgment on moderate difficulty claims and policy coverages and determines if coverages apply to claims submitted. Investigates, evaluates, negotiates and adjudicates first and third party claims to...
-
Claim Examiner- WC
1 week ago
Minneapolis, Minnesota, United States Hornet Staffing Full time:Receives claim assignment, confirms policy coverages and directs acknowledgement of claims. Interprets and makes decisions using independent judgment on moderate difficulty claims and policy coverages and determines if coverages apply to claims submitted. Investigates, evaluates, negotiates and adjudicates first and third party claims to determine validity...
-
Subrogation Claims Specialist
1 week ago
Minneapolis, Minnesota, United States Element Fleet Corporation Full timeGet started on an exciting career at ElementElement employees make a difference in the lives of others every day. We are re-defining the fleet management industry to be people first, then business - delivering on our promise of a superior client experience. This takes hard work and innovation, and we need more like-minded people on our team.What We NeedWe...
-
Subrogation Claims Specialist
3 weeks ago
Minneapolis, Minnesota, United States Element Fleet Corporation Full timeGet started on an exciting career at ElementElement employees make a difference in the lives of others every day. We are re-defining the fleet management industry to be people first, then business - delivering on our promise of a superior client experience. This takes hard work and innovation, and we need more like-minded people on our team.What We NeedWe...
-
Content Claims Specialist
1 week ago
Minneapolis, Minnesota, United States Crawford & Company Full timeExcellence In Everything We TouchPosition SummaryThe role of Content Claims Specialists is a multi-faceted role, which focuses primarily in the following four key areas of edjuster's content claims handling operations: Acting/operating as a third party, intermediary between the Insurance Company's property adjusters, and their policyholders with respect to...
-
Insurance Representative
2 months ago
Minneapolis, Minnesota, United States Optum Full time$1,000 sign on bonus for external candidatesOpportunities at Optum, in strategic partnership with Allina Health. As an Optum employee, you will provide support to the Allina Health account. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their...
-
Insurance Representative
1 month ago
Minneapolis, Minnesota, United States Optum Full time$1,000 Sign-on Bonus for External CandidatesOpportunities at Optum, in strategic partnership with Allina Health. As an Optum employee, you will provide support to the Allina Health account. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their...
-
Content Claims Specialist
4 weeks ago
Minneapolis, Minnesota, United States Crawford & Company Full timeContent Claims Specialist - Field - Level IIRequisition ID Job LocationsUS-MN-Minneapolis | US-MN-Saint Cloud | Rochester | US-WI-Eau ClairePosition TypeRegular Full-TimeCategoryClaimsBusiness UnitCUS_Loss Adjusting USExcellence In Everything We TouchPosition SummaryThe role of Content Claims Specialists is a multi-faceted role, which focuses primarily in...
-
Content Claims Specialist
1 month ago
Minneapolis, Minnesota, United States Crawford & Company Full timeContent Claims Specialist - Field - Level IIRequisition ID Job LocationsUS-MN-Minneapolis | US-MN-Saint Cloud | Rochester | US-WI-Eau ClairePosition TypeRegular Full-TimeCategoryClaimsBusiness UnitCUS_Loss Adjusting USExcellence In Everything We TouchPosition SummaryThe role of Content Claims Specialists is a multi-faceted role, which focuses primarily in...
