SUMMARY : We are currently seeking a RCM Representative Senior to join our Third-Party Claims-HB&PB team. This full-time role will primarily work remotely (Days, M- F).
- Purpose of this position :
- Working under general supervision, provides revenue cycle services to incoming and existing patients and their families either in person or by telephone. Is responsible for gathering patient information needed to provide services such as following up on complex claim issues, financial clearance, customer service, or admission. Works will be assigned via a work queue in the electronic health record system
Current List of non-MN States where Hennepin Healthcare is an Eligible Employer : / Current List of non-MN States where Hennepin Healthcare is an Eligible Employer : Alabama, Arizona, Arkansas, Delaware, Florida, Georgia, / / Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Mississippi, Nevada, North Carolina, North Dakota, New Mexico South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin. / / /
RESPONSIBILITIES :
Gathers information from patients, clients / family members, HCMC clinical areas, government agencies, employers, third party payors, and / or medical payment programs, etc. both in-person and by telephone to register patients, gather or update information, obtain referrals and pre-authorizations, complete appropriate forms, conduct evaluations, determine benefits and eligibility (insurance, public programs, etc.), determine financial responsibility, and / or to identify sources of payment for servicesRequests, inputs, verifies, and modifies patient’s demographic, primary care provider, and payor informationUtilizes tools, including computer programs, when indicatedMakes appropriate referrals (i.e. Patient Financial Care Specialists, Collections Specialists) as appropriateProvides excellent customer service and timely response to questions and issues related to benefits, billing, claims, payments, etc.Answers questions (by phone and in-person) and provides quotes for services (including discounts), identifies financial resources, etc. in accordance with HCMC policies and proceduresUtilizes various databases and specialized computer software for financial care activities including eligibility verifications, pre-authorizations, medical necessity, review / updating of patient accounts, etc.Establishes plans (patient liabilities, payment, etc.) and conducts follow up activities related to those plansInputs, retrieves, and modifies information and data stored in computerized systems and programs; generates reports using computer softwareExplains charges, answers questions, and communicates a variety of requirements, policies, and procedures regarding patient financial care services and resources to patients, staff, payors, and agenciesWorks with Claims and Collections (both internally and with collection agencies) in order to assist patients and their families with billing and payment activities in order to increase cash flowOther duties as assignedQUALIFICATIONS : / Minimum Qualifications : /
2 years clerical experience in health care revenue cycle operations : billing / claims, patient accounting, collections, admissions, registration, etc.Bilingual strongly preferred, required in some positionsAn approved equivalent combination of education and experiencePreferred Qualifications : /
Demonstrated organizational skills and the ability to prioritize and manage tasks based on established criteriaExcellent verbal and written communication and interpersonal skillsAbility to work independently with minimal supervision, within a team setting and be supportive of team membersProficient with Microsoft OfficeAbility to analyze issues and make judgments about appropriate steps toward solutionsCRCR (Credentialed Revenue Cycle Representative) preferredKnowledge / Skills / Abilities : /
Knowledge of patient billing claims processAbility to communicate with patients and families under sometimes stressful circumstancesStrong telephone communication skillsExperience with electronic health record or similar software programKnowledge of payor programsKnowledge of applicable federal and state regulationsTitle : RCM Representative Senior, Third-Party Claims-HB&PB
Location : MN-Minneapolis-Downtown Campus
Requisition ID : 250394
