Revenue Cycle Financial Specialist

Job Description

Join one of the nation’s most comprehensive academic medical centers, UChicago Medicine, as a Revenue Cycle Financial Specialist with the Revenue Cycle - Patient Access Services Department. In this role, you will be responsible for collecting and verifying demographic, guarantor and insurance information, educating patients, physicians, staff, etc., on the financial process.

• Responsible for ensuring that preauthorizations, referrals and precertifications are 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.

• 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 as 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 precertifications to ensure reimbursement of services rendered. Document necessary authorization information in appropriate fields for clean billing and payment.
• Recognize patients in need of financial assistance, and provide charity applications or referrals to the Department of Human Services.
• 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 Pro Fee 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 patients with financial assistance applications.
• Ensure completed Financial Assistance applications get routed to the appropriate department for consideration in a timely manner.
• Work closely with both the patient and UCM MA-NG vendor to assist in the completion of the Medicaid application. This will ensure that the Medicaid applications are completed in a timely manner.
• 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 require administrative intervention or review.
• Meet daily productivity and quality expectations and participate openly in…