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 position, 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 payer 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 demographic, guarantor, insurance, and financial 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 hospital financial policies.
- Advise patients and guarantors on rights, responsibilities, and payment procedures for hospital and professional fee care.
- Act as an advocate to resolve inquiries and ensure positive guest relations.
- Use available resources to identify appropriate financial resolutions for patients and the organization.
- Stay current on regulations affecting healthcare billing, including Affordable Care Act and Fair Patient Billing Act guidelines.
- Assist patients with financial assistance applications and ensure timely routing for consideration.
- Collaborate with Medicaid application vendors to facilitate timely completion of applications.
- Support patients in understanding Health Insurance Exchange plans and initiating application processes.
- Collect payments due prior to services using the PPE system through PASSPORT.
- Investigate and resolve charge disputes, process refunds, identify account adjustments, and make corrections.
- Arrange payment plans for past due balances.
- Escalate issues requiring administrative intervention per treatment policy.
- Meet daily productivity and quality standards and participate in departmental audits and reviews.
- Perform other duties as assigned.
Requirements
- Minimum of two (2) years' experience in medical insurance verification and hospital finance areas, including hospital billing.
- Proficiency with Windows-based PC systems.
- High initiative and strong problem-solving skills.
- Strong analytical and financial assessment abilities with attention to detail.
- Ability to multitask and adapt in a constantly changing environment.
- Independent problem-solving capability and strong team management investment.
- Knowledge of accounting principles.
- Excellent verbal, math, and presentation skills.
Preferred Qualifications
Compensation & Benefits
- Full-time position (1.0 FTE).
- Day shift.
Location
- Flexible remote work option or based in Burr Ridge, Illinois.
Department
- Revenue Cycle - Patient Access Services
Additional Information