RCM Representative Sr, Third-Party Claims

2 months ago

Minneapolis, United States Minnesota Visiting Nurse Agency Full time

*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. Responsible for gathering patient information needed to provide services such as following up on complex claim issues, financial clearance, customer service or admission. Work 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. Bi-lingual 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 Title: RCM Representative Sr, Third-Party Claims - HB & PB Location: MN-Minneapolis-Downtown Campus Requisition ID: 231464

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