RCM Specialist

JOB DETAILS

Department:

Financial Securing FTE:

1.00 (80 hours per pay period)

Workdays:

Monday

• Friday and Rotating Weekends Shift(s):

Days Shift Length:

8 hours

Location:

In-Person Purpose of this position: The Financial Counselor serves as Hennepin Healthcare's primary contact for patient reimbursement issues in accordance with established credit and Financial Counseling policies. Provides information regarding hospital payment requirements, alternative financing, and charity care programs. All communications are conducted in a manner that will result in positive patient relations and prompt reimbursement for services. The responsibilities of the Financial Counselor include functions listed below as well as other duties as assigned.

RESPONSIBILITIES

• Meets with patients that present as self-pay or under-insured to obtain valid insurance coverage, confirms eligibility if applicable, and/or review prior accounts to update insurance coverage information;
• Notifies the appropriate departments of coverage information when necessary and enters account notes into the electronic medical record
• Educates, screens, and assists patients without valid insurance coverage with enrollment in programs including, but not limited to, Medicaid, other state-based and commercial-based assistance programs, and financial assistance
• Work closely with Social Services team to resolve financially related barriers that prevent the safe discharge of an inpatient to either the community or next appropriate care facility
• Works closely with Hennepin County DHS team to expedite applications that will assist in timely discharge
• Communicates with nursing home/rehab facility/etc on pending Medicaid application to assist in our patient being accepted to their facility, also to support timely discharge
• Collects monies from patients prior to admission and/or prior to discharge, including outstanding accounts receivable, advanced down payments from self-pay patients, and co-pays and deductibles from insured patients
• Work with the Division of Expanded Care team to get appropriate forms and applications completed when a patient needs a State of MN disability determination
• Educates patients on applicable policies, such as point of service collections, payment plans, and financial assistance eligibility during the interview process
• Researches, identifies, and rectifies any special circumstances affecting delayed payment of self-pay accounts
• Works in conjunction with on-site clinical care team or outside eligibility vendor to assist in the appropriate completion of Medicaid applications, ensuring this funding source is maximized based on patients' eligibility
• Continues to stay informed of any statutes and regulations that could affect the collection of receivables (i.e., insurance company changes, collection regulations, etc.)
• Confers with third parties on the completion of forms, patient financial information, financial obligations, and hospital credit policy
• Meet and maintain initial and ongoing MN DHS and MnSure requirements and certifications that relate to performing the job functions of a Financial Counselor
• Completes procedures for filing Medicaid applications and/or other public assistance programs
• Follows up with all patients and necessary entities who need to return outstanding verifications for the determination of their eligibility for an assistance program
• Respond timely, accurately and professionally to patient and external and internal business partners, via phone, email, mail as appropriate
• Complete, process, follow up and approve or deny all financial assistance applications for the organization

Qualifications:

QUALIFICATIONS

Minimum Qualifications:

• 2 year degree in Accounting, Business, Healthcare Administration, Health & Human Services or related field
• 2-3 years exposure to payor systems and/or knowledge of public financial resources
• Bi-lingual strongly preferred, required for some positions
• OR•An approved equivalent combination of education and experience

Preferred Qualifications:

• Bachelor's degree in Accounting, Business, Healthcare Administration or related field
• Understanding of Managed Health Care
• Demonstrated organizational skills and the ability to prioritize and manage tasks based on established criteria
• Excellent verbal and written communication and interpersonal skills
• Ability to work independently with minimal supervision, within a team setting and be supportive of team members
• Proficient with Microsoft Office
• Experience using electronic health record or similar software program
• Ability to analyze issues and make judgments about appropriate steps toward solutions
• CRCR (Credentialed Revenue Cycle Representative) certification preferred
• Bilingual preferred

Knowledge/Skills/Abilities:

• Familiarity with statutes and regulations that impact collection of past-due accounts
• Broad knowledge of government assistance programs, guidelines, and application procedures
• Able to communicate and respond to inquiries; requires effective interpersonal skills and ability to interact with patients to explain payment policies and persuade patients to settle account balances
• Experience using carious computer programs (Microsoft Office, OnBase, Rightfax Epic)