Revenue Cycle Representative - Emergency Department (ED) - Medical Center North Liberty (MCNL) - Patient Access Management (PAM) - PFS

Position Responsibilities

• Respond to patient/visitors/family requests and directs to the appropriate areas in a timely manner.
• Verify insurance benefits to determine if insurance will reimburse UI Health Care for services provided and ensure that insurance data entered is accurate and complete.
• Determine insurance company and financial status classification; enter information accurately and completely into the Billing system and be expected to maintain a high-level of accuracy to meet productivity and quality requirements.
• Confirm co-pay amount and collect from patient as appropriate for the visit and practice safe cash handling procedures to ensure batches reconcile at end of shift.
• Determine priority of work and work collaboratively with clinical staff in processing of paperwork, lab requests, patient requests, etc. - Prioritize patient visits based on based on admission status and total stay time, according to protocols)
• Complete Medicare Secondary payer questionnaire to correctly identify primary payer for accurate claim submission and compliance regulations. Identify and determine referral and prior authorization requirements.
• Contact appropriate internal resources to coordinate financial assistance activity, as needed. Assist other clinical departments with inquiries regarding various aspects of patients’ accounts.
• Answer multiple incoming telephone lines and direct to appropriate parties.
• Independently determine appropriate forms and patient signatures that are required and facilitate the securing of patient signatures on forms such as: HIPAA Consent

Qualifications

• Education Required: Bachelor’s degree or an equivalent combination of education and experience.
• Experience Requirements: 6 months or more of related customer service experience in a professional, financial or health care related environment. Strong attention to detail and proven ability to gather and analyze data and keep accurate records. Proficiency with computer software applications, i.e. Microsoft Office Suite (Excel, Word, Outlook, PowerPoint) or comparable programs and an ability to quickly learn and apply new systems knowledge. Demonstrated ability to handle complex and ambiguous situations with minimal supervision. Self-motivated with initiative to seek out additional responsibilities, tasks, and projects. Effective communication skills (written and verbal), active listening skills and the ability to maintain professionalism while handling difficult situations with callers or customers. Successful history collaborating in a fast-paced team environment. Demonstrated ability to follow policies and procedures while escalating issues as needed.
• Desirable Qualifications: Demonstrated ability to maintain or improve established productivity and quality requirements. Knowledge of Health Insurance Portability and Accountability Act (HIPAA) laws. Knowledge of healthcare billing (healthcare revenue cycle); insurance, and/or federal and state assistance programs. Familiarity with medical terminology. Experience identifying opportunities for improvement and making recommendations and suggestions. Experience with multiple technology platforms such as GE, Cirius ACD, and/or Epic. Ability to drive results and foster accountability throughout the team and organization. Maintain current awareness of industry trends and continually strive for improvement with both technical and professional skills.