Revenue Cycle Financial Specialist, Full Time- Days

Overview

A healthcare organization is seeking a Revenue Cycle Financial Specialist to join the Revenue Cycle - Patient Access Services Department. This is a full-time, remote work-from-home opportunity, with flexibility to be based outside the greater Chicagoland area.

Responsibilities

• Collect and verify patient demographic, guarantor, and insurance information.
• Educate patients, physicians, and staff on financial processes.
• Ensure preauthorizations, referrals, and precertifications are completed according to payor requirements before scheduled encounters.
• Collaborate with clinical staff to obtain necessary clinical information for authorization processes.
• Assist patients and their representatives in securing reimbursement for hospital and physician services.
• Help patients identify and select insurance coverage options or financial assistance.
• Work collaboratively with coverage vendors, clinical staff, patient financial services, ambulatory patient financial specialists, urban health collaborative, and case management/social work.
• Manage all patient account types including outpatient, inpatient, emergency department, and physician group accounts.
• Maintain thorough knowledge of the hospital's revenue cycle processes and inpatient/outpatient treatment policies.
• Coordinate and monitor revenue flow generated by hospital and physician group services.
• Utilize hospital revenue systems and interact regularly with patients, physicians, insurance companies, donors, and staff.

Essential Functions

• Conduct patient interviews via telephone or face-to-face to collect required registration data.
• Verify insurance benefits and coverage for scheduled services.
• Prioritize work to ensure completion before patient appointments.
• Obtain necessary referrals, authorizations, or precertifications to ensure reimbursement.
• Document authorization information accurately for clean billing and payment.
• Identify patients needing financial assistance and provide charity applications or referrals.
• Assist in managing resolution of multiple visit accounts in compliance with financial policies.
• Advise patients and guarantors on rights, responsibilities, and payment procedures.
• Advocate for positive guest relations and resolution of inquiries.
• Use available resources to identify appropriate financial resolutions.
• Stay current on regulations affecting healthcare billing and financial assistance programs.
• Assist patients with financial assistance and Medicaid applications, working closely with vendors.
• Support patients in understanding Health Insurance Exchange plans.
• Collect payments due prior to services using designated systems.
• Investigate and resolve charge disputes, process refunds, identify account adjustments, and make payment arrangements.
• Escalate issues requiring administrative review per treatment policy.
• Meet daily productivity and quality standards and participate in departmental audits.
• Perform other duties as assigned.

Requirements

• Minimum of two (2) years of experience in medical insurance verification and hospital finance areas, including hospital billing.
• Proficiency with Windows-based PC systems.
• Strong initiative, problem-solving skills, and ability to multitask in a dynamic environment.
• Excellent analytical and financial assessment abilities with attention to detail.
• Ability to work independently and contribute to team management.
• Knowledge of accounting principles.
• Excellent verbal, math, and presentation skills.

Preferred Qualifications

• Bachelor's degree.

Compensation & Benefits

• Full-time position (1.0 FTE) with day shift hours.
• Compensation is competitive and based on qualifications, experience, and organizational considerations.
• Benefits package available for eligible employees.

Location

• Flexible remote work option with a possible location in Burr Ridge, Illinois.

Additional Information

• The role requires compliance with pre-employment physical, background check, drug screening, and flu vaccination requirements, with medical and religious exemptions considered as applicable.
• The organization is an equal opportunity employer and evaluates qualified applicants without regard to legally protected characteristics.