Revenue Cycle Financial Specialist - PFX, Full time - Days

Job Description

Be a part of a world-class academic healthcare system, Uchicago Medicine, as a Rev Cycle Financial Specialist - PFX in Rev Cycle Admin Department. This position requires you to work onsite 1 week and WFH 4 weeks. You will need to be based in the greater Chicagoland area.

In this role Revenue Cycle Financial Specialist-PFX 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

• 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
• Recognizes those patients in need of financial assistance, and provides 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 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
• Assists 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 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:  M-F
• Office Location: Rotational Remote- Hyde Park (UChicago Main Campus)
• Unit/Department: Revenue Cycle
• CBA Code: 743 Clerical

Why Join Us

We’ve been at the forefront of medicine since 1899. We provide superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, we need employees with passion, talent and commitment… with patients and with each other. We’re in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you’d like to add enriching human life to your profile, UChicago Medicine is for you. Here at the forefront, we’re doing work that really matters. Join us. Bring your passion.

UChicago Medicine is growing; discover how you can be a part of this pursuit of excellence at: UChicago Medicine Career Opportunities.

UChicago Medicine is an equal opportunity employer.  We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.

Must comply with UChicago Medicine’s COVID-19 Vaccination requirement as a condition of employment. If you have already received the vaccination, you must provide proof as part of the pre-employment process. This is in addition to your compliance with the Flu Vaccination requirement as well. Medical and religious exemptions will be considered consistent with applicable law. Lastly, a pre-employment physical, drug screening, and background check are also required for all employees prior to hire.

Compensation & Benefits Overview

UChicago Medicine is committed to transparency in compensation and benefits.  The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position.

The pay range is based on a full-time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis. Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity. Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union.

Review the full complement of benefit options for eligible roles at Benefits - UChicago Medicine.