Revenue Cycle Financial Specialist

2 weeks ago

Chicago, United States The University of Chicago Medicine Full time

**Job Description**:
Join one of the nation’s most comprehensive academic medical centers, **UChicago Medicine**, as a **Revenue Cycle Financial Specialist **with the **Finance Revenue Cycle Department** collect and verify demographic, guarantor and insurance information.

**Local Remote Opportunity**

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.

**Job Summary**
- Responsible for ensuring that preauthorization’s/referrals and precertification’s are in completed in accordance with payor requirements and prior to the scheduled encounter.
- Work closely with the staff in the clinical areas to acquire necessary clinical information needed to complete 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 hospitals revenue cycle process
- Understand the Hospitals Inpatient/Outpatient treatment policies and how they relate to each patient situation Have the responsibility of coordinating and monitoring the flow of revenue generated not only by UCMC but UCPG
- You will be involved in extensive utilization of the Hospitals revenue systems and constant interaction with patients, physicians, insurance companies, donors and other members of the Hospitals' staff

**Essential Functions/Responsibilities**
- Perform all registration functions: interview patients via telephone or face to face to collect demographic, guarantor, insurance and financial data required
- Verify the benefits as well the 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 precertification’s to ensure reimbursement of services rendered Document necessary authorization information in appropriate fields for clean billing and payment
- Interview the patients to be able to assist in managing a resolution of a patient’s multiple visit accounts and be compliant 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 ProFee 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 regulation(s) that may change the structure and management of the current Affordable Health Care Act or Fair Patient Billing Act guidelines
- Assist the patient in understanding the 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 that require administrative intervention or review
- Meet daily productivity and quality expectations and participate openly in departmental audit/review process to ensure that all work is monitored and completed based on departmental standards.
- Other Duties Assigned

**Required Qualifications**:

- Two ( 2 ) years’ experience in medical insurance verification and other hospital finance areas (including Hospital Billing)
- Windows based PC experience
- High degree of initiative and problem solving ability
- Strong analytic and financial assessment abilities as well as the ability to pay close attention to a variety of details are required in order to perform duties effectively
- Must be able to multitask and be able to function in a constantly changing environment.
- Requires the ability to problem solve independently and must be strongly invested in team management
- Must have knowledge of accounting principles with excellent verbal, math and presentation skills

**Preferred Qualifications**:

- Bachelor’s degree

**Position Details**:

- Job Type/FTE: Full Time (1.0 FTE)
- Shift: Days
- 7:00am-3:30pm M-F
- Unit/Department: Revenue Cycle
- Patient Access Services
- CBA Code: 743 Clerical
- Must comply with UCMC’s COVID-19 Vaccination

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