Financial/Referral Specialist-Full Time- Chicago

Department: 37300 Advocate Illinois Masonic Medical Center - Administration: Cancer Status: Full time Benefits Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: Monday thru Friday 7:30 am until 5:30pm Address: 900 W. Nelson St. Chicago, IL 60657 Office Hours: Monday thru Friday 7:30 am until 5:30pm Major Responsibilities: Conducts case by case financial evaluation of all admissions in order to promote funding our future. 4)Works closely with outside firms for Self Pay, eligibility and liability collections to integrate work flow to enhance collections and ensure patient satisfaction. 5)Reviews documentation in order to prepare a written summary outlining the patient’s financial situation to be reviewed by the Business Services Supervisor. 6)Assists patients in resolving issues with third party payors that would delay payment from their insurance carriers. Delays can be caused by claims forms, cob forms or liability information. 7)Contacts the attending physician when patients are “out-of-plan” or coverage issues. has been terminated by their insurance carrier. 8)Counsels patients on the specific requirements of their insurance plans related to the treatments planned for the cancer center. Counsels patients on resources to meet financial challenges. 2)Screens patients through financial interview to determine if the patient meets eligibility requirements for possible assistance through the Illinois Department of Public Aid aka Department of Human Service Medical Assistance Program MANG program or IBCCP Illinois Breast and Cervical Cancer Program. 3)Maintains thorough knowledge of Allegra strategies and account flow to ensure specific accounts are correctly classified with appropriate strategy, collector ID, stop statement and vendor codes to avoid incorrect, delayed or premature transfer to a third party or bad debt firm 9)Completes QCLs and other related work requests in a timely fashion 10)Evaluates the patient's financial needs as it relates to the services they will be receiving at the cancer center. This position must understand what the patient may need from the AMG and AIMMC teams with regard to financial advocacy. 1)Screens and financially evaluates patients who are referred by physicians, social service or other hospital departments to determine if they meet financial requirements to qualify for discounted or charity rates or medicaid. Provides consistently accurate counseling to patients related to insurance verification, cash collections and referral processing to promote growth. 1)Accurately asks patients to provide us the correct demographic information and enter information in system accurately. Responsible for verify insurance coverage, gather referrals, collect copayments and enter into patient EMR/ IDX system. 2)Educates patient on referrals and copayments that needs to be collected at the time of service. Collects all copayments and referrals and enter into AMG and Mosiaq system at the time of service. 3)Ensures all patients seen with HMO insurance have a valid referral at the time of service. Responsible for closely working with case manager to assist with any referral issues. 4)Educates patients on their specific insurance provider guidelines and counsels patients on their financial responsibilities. 5)Facilitates communication with external resources to assist patients in meeting financial needs to optimize collections. 6)Responsible for setting up payment options for certain services and procedure. 8)Collaborates with the Business Services Supervisor to create patient education materials related to financial challenges. 9)Responsible for working with Patient Access Representative and Case Management Department regarding follow up status on referrals daily. 10)Responsible for obtaining referral for outpatient services and procedures from PCP in a timely manner 7)Assists the Business Services Supervisor with creation and maintenance of productivity statistics for the department. Communicates and documents patient's financial status and related interventions to the rest of the care team by submitting timely entries into the EMR and utilizing other communication tools to promote physician and associate engagement 1)Scans all relevant documents into the EMR per department standards 2)Attends relevant case conference meetings to gain patient referrals and be a resource to physicians and staff 3)Refers patients to Financial Navigator as appropriate for insurance options available for patients 4)Collaborates with Case Managers, SW to promote financial advocacy for our patients 5)Provides educational inservices to physicians and associates to update the team on any issues that relate to financial advocacy. 6)Collaborates with both the AMG and AIMMC financial teams and other caregivers to assure financial advocacy for our patients 7)Responsible for making financial arrangements with self pay and insured patients who are being transferred from other hospitals when referred by on staff physicians in accordance with the hospital's and physican credit and collection policy 8)Conduct financial interviews with patients who request or appear to be eligible for charity consideration through the AMG or AIMMC charity programs. Refer patients as appropriate to departments for assistance. 9)Report monthly statistic on patients to supervisor 10)Ensure all referral obtained for all services are logged and scanned in all appropriate systems in a timely manner. Attends AMG and AIMMC meetings related to financial advocacy to keep current on knowledge of technical systems and regulations. 1)Attend monthly Cancer Center and departmental meeting. 2)Communicate to staff any insurance changes and updates for AIMMC and AMG departments. Such as policy that are no longer active. Education/Experience Required: . High school diploma or equivalent. Bachelor's Degree preferred . 1-2 years in a medical setting or equivalent. 2-3 years of customer service experience in a high volume, multiple task, high stress environment. Plus 1 year hospital or medical office collections or financial counseling experience .Experience handling difficult callers, customers and patients. . Basic knowledge of managed care and commercial insurance. . Basic knowledge of medical terminology and billing and coding practices. . Familiarity with all third party payors . Familiarity with IDPA eligibility for the MANG program . Previous verification experience Knowledge, Skills & Abilities Required: . Excellent communication and customer service skills. . Demonstrates excellent ability to establish and maintain effective personal relationships. . Comprehensive ability to conceptualize and follow office policies and procedures. . Ability to handle stressful situations. . Able to function in a high-volume, multiple task environment producing quality work. . Able to work independently and problem solve. . Strong interpersonal and telephone communication skills. . Solid PC skills. .Working knowledge of automated appointment scheduling. . Previous experience with Allegra or patient accounting information system. . Experienced in PC and Windows applications and Microsoft Excel None Physicial Requirements and Working Conditions: Demonstrates tact and good judgment. Mature, motivated, decisive and flexible. Professional demeanor. Ability to work in a diverse professional and patient population. Ability to work under stressful conditions and with demanding customers. Bilingual in Spanish preferred. Excellent communications skills strong analytical skills- strong interpersonal skills-ability to work independently-ability to make decisions If position has direct patient care or direct patient contact the following lifting requirement supersedes any previous lifting requirement effective 06/01/2015. Ability to lift up to 35 pounds without assistance. For patient lifts of over 35 pounds, or when patient is unable to assist with the lift, patient handling equipment is expected to be used, with at least one other associate, when available. Unique patient lifting/movement situations will be assessed on a case-by-case basis. This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. Advocate Aurora Health is one of the 10th largest not-for-profit, integrated health systems in the U.S. with nearly 3 million patients served at more than 500 sites of care in Illinois and Wisconsin, including 28 hospitals. We're redefining the standard for care with world-class doctors and caregivers, innovative solutions, outstanding outcomes, and leading-edge research and clinical trials. Combined, Advocate and Aurora are recognized for clinical excellence in a variety of specialties. Advocate Aurora Health is one of the 10th largest not-for-profit, integrated health systems in the U.S. with nearly 3 million patients served at more than 500 sites of care in Illinois and Wisconsin, including 28 hospitals. We're redefining the standard for care with world-class doctors and caregivers, innovative solutions, outstanding outcomes, and leading-edge research and clinical trials. Combined, Advocate and Aurora are recognized for clinical excellence in a variety of specialties. This is Transformation One shared purpose brought us together. Now, as one of the 10 largest not-for-profit, integrated health systems in the United States, our combined strength and stability drives us forward. Starting with You Caring for nearly 3 million people has inspired a transformation. One in which the patient’s experience guides our vision and empowers us to offer new possibilities in our communities. Reshaping Access What is access? It’s offering more sites of care than any other health system in the Midwest. But there’s a new frontier. Access is exploring the latest technologies to deliver care to patients exactly where they are and exactly when they need it Inspiring Professionals With our dynamically inclusive workforce and strong connections to the places where we live and work, we’ll touch more lives and contribute to stronger and more vibrant communities. Transforming Care We’re redefining the standard for care with world-class doctors and caregivers, innovative solutions, outstanding outcomes, and leading-edge research and clinical trials. Combined, Advocate and Aurora are recognized for clinical excellence in: Cardiovascular Care Neurosciences Gynecology Oncology Pediatrics Primary Care Neurology Geriatrics Trauma Care