Revenue Cycle Financial Specialist

About Our Client

The organization operates within the academic healthcare industry, focusing on delivering comprehensive medical services. It addresses challenges in patient financial access and support within a complex healthcare revenue cycle. By providing integrated patient access services and financial assistance programs, the organization aims to streamline billing processes and improve patient financial experiences across inpatient, outpatient, and emergency care settings.

About the Opportunity

The Revenue Cycle Financial Specialist plays a critical role in managing patient financial interactions and the revenue cycle process. This position is responsible for collecting and verifying patient and insurance information, securing necessary authorizations prior to care, and assisting patients in navigating insurance and financial assistance options. The role contributes to ensuring accurate billing, timely reimbursements, and positive patient financial outcomes while supporting the overall financial health of the organization.

Responsibilities

• Collect and verify demographic, guarantor, and insurance information from patients.
• Ensure preauthorizations, referrals, and precertifications are completed per payor requirements before scheduled encounters.
• Collaborate with clinical staff to obtain necessary clinical information for authorization processes.
• Absorb and assist patients and representatives in securing reimbursement for hospital and physician services.
• Guide patients in selecting insurance coverage or financial assistance options.
• Cook with internal teams and external vendors to support patient coverage and financial services.
• Manage patient accounts across outpatient, inpatient, emergency, and physician group services.
• Understand and apply inpatient and outpatient treatment policies related to patient billing.
• Perform patient interviews to collect financial data and resolve multiple-visit account issues.
• Advise patients and guarantors on payment responsibilities and procedures.
• Advocate for patients to resolve billing inquiries and identify appropriate financial resolutions.
• Stay informed on regulations affecting healthcare billing and financial assistance.
• Absorb and ensure timely processing of financial assistance applications.
• Support Medicaid application processes in collaboration with vendors.
• Educate patients on Health Insurance Exchange plans and facilitate enrollment support.
• Collect payments prior to service delivery using established systems.
• Investigate and resolve charge disputes, process refunds, and adjust accounts.
• Escalate issues requiring administrative intervention according to policy.
• Maintain productivity and quality standards and participate in audits.
• Perform other duties as assigned.

Requirements

• Minimum two years of experience in medical insurance verification and hospital finance, including billing.
• Proficiency with Windows-based PC systems.
• Strong initiative, problem-solving skills, and attention to detail.
• Ability to multitask and adapt in a dynamic environment.
• Independent problem-solving capability with a team-oriented approach.
• Knowledge of accounting principles and strong verbal, math, and presentation skills.
• PREFERRED: Bachelor’s degree.

Pay Range and Compensation Package

The pay range and compensation package for this role will be determined based on the candidate’s experience, skills, and other relevant factors.

Equal Opportunity Statement

Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.