NWIN Cancer Insurance Specialist

Join a world-class academic healthcare systemUChicago Medicine Crown Point located in Crown Point Indiana as a Cancer Insurance Specialist. UChicago Medicine is an integrated academic and community health system with multiple primary medical facilities within the surrounding suburbs of Chicago. UChicago Medicine Crown Point is a new two-story 130000-square-foot multispecialty care center and micro-hospital in Northwest Indiana for what will be the academic health systems largest off-site facility and its first freestanding building in Indiana.

The Crown Point care center will include:

• A micro-hospital with an eight-bed emergency department and a short-stay inpatient unit
• A comprehensive cancer center with infusion therapy as well as radiation medical and surgical oncology
• An imaging center with MRI CT PET X-ray and ultrasound capabilities
• An outpatient surgery center
• Laboratory services
• Medical offices with access to UChicago Medicines physicians and specialists including those in cancer care cardiology digestive diseases orthopaedics neurosciences pediatrics primary care surgical specialties transplant care and womens health

Job Summary:

• Responsible for pre-registration insurance verification and payer authorizations of inpatients and outpatients and educating patients about their financial responsibilities and resources to assist with same. Works with patient and families and collaborates with members of the clinical and administrative team including Patient Access and Call Center teams from the point of initial referral through clinical evaluation and continuing through active treatment and for follow-up visits. Requires extensive utilization of Hospital revenue systems and continuous interaction with patients physicians insurance companies and other member of the Hospitals and Biological Science Division staff. Routinely interacts with the insurance companies to ensure proper payments for all cancer-related services and serves as an advocate for the patient when billing problems occur.
• The (Cancer) Insurance Specialist advises patients of anticipated costs. Works with health insurance providers to determine coverage benefit limits and financial responsibility. Uses the patients electronic health record to both access and document information which supports authorization therefore ensuring a systematic approach to sharing critical information. Networks with other precertification/insurance employees across UCMs billing entities to stay abreast of and share recent changes updates and processes. Provides complete information to the Single Case Agreement Team on initial request in an effort to facilitate a standardized and systematic process for non-par insurance plans. Maintains and develops clear lines of communication with insurance representatives from multiple insurance companies who can provide precertification/authorization guidelines unique to their company. Must be able to effectively manage work across departments work independently with minimal supervision and participate in administrative decisions. Embodies a compassionate and tactful manner. Strong communication skills attention to detail problem solving and a high degree of organization are critical qualities

Job Functions:

• Collects and verifies demographic information insurance coverage plan benefits and referring physician data for (cancer) patients. Uses all necessary and available electronic systems and tools.
• Discusses in-person (preferred) or telephonically benefits and financial information with all referred (cancer) patients and their families prior to initial evaluation. Provides face-to-face or telephonic financial counseling and information regarding the insurance to patients families and related Hospital staff.
• Obtains detailed patient insurance benefit information from point of initial referral including initial consult diagnostic work-up hospitalization(s) and follow-up clinic visits.
• Collaborates with Social Worker and/or Pharmacy to provide information to patients and their families regarding available financial assistance resources. Assists patients in completing necessary documents to apply for financial assistance free care special pharmacy benefits etc.
• Assists patients in answering billing questions and facilitates resolution of issues.
• Communicates/Educate family and/or responsible party as necessary to inform them of any insurance problems or restrictions ensuring that insurance information is clearly relayed to and understood by family and/or responsible party.
• Completes abbreviated assessment to determine family eligibility for Charity Care programs for handoff to Revenue Cycles approvals team (located offsite in Darien office).
• Communicates and coordinates as necessary with Patient Access team to share information and reduce redundancy.
• Initiates appropriate handoffs to other insurance specialists and departments as patient moves from one clinical service to another to ensue continuous monitoring of benefits and obligations while communicating same among colleagues.
• Communicates initially with Call Center regarding intake information and then proactively and directly with the clinical team regarding status of authorization and the need for clinical documentation
• Monitors and updates information regarding insurance data physicians authorizations and preferred providers.
• Obtains all necessary payor authorizations for cancer care. Verifies coverage and other medical benefits and acquires necessary referrals and authorizations. Confirms pre- authorizations for procedures. Verifies receipt of and facilitates managed care referrals for office visits. Documents insurance coverage and authorization information in EPIC.
• Documents all relevant information into EPIC
• Partners with Single Case Agreement Department to facilitate non-par cases to obtain care/treatment
• Responds to incoming calls regarding account status from patients and insurance companies
• Performs other duties assigned

Qualifications:

• Bachelors degree or equivalent and/or 2 years experience working in medical insurance verification and/or other healthcare finance areas.
• Minimum of five years related healthcare registration billing and/or reimbursement experience required.
  

Preferred Skills:

• Advanced insurance authorization and registration techniques required
• Previous experience in complex clinical setting that required coordination of multiple services
• Resource scheduling experience preferred (e.g. ancillary testing)
• Background in medical terminology; (Oncology) experience preferred
• Website Insurance Training (Navinet WebMD Passport)
• EPIC training & testing (Prelude/Cadence).
• Registration Essentials
• Windows-based PC experience
• Ability to schedule and register patients rapidly and accurately.
• Strong communication skills and must be able to communicate courteously and effectively with physicians payers and staff.
• Must be a self-motivated
• Individual must be highly organized and dependable and able to work with minimum of supervision

Position Details

• Job Type: Full Time (1.0FTE)
• Shift: Days- 8am - 5pm (Rotational Remote) M-F
• Office Location when onsite is required: NWIN - Crown Point Location
• Unit: Revenue Cycle- Patient Access Services
• CBA Code: Non-Union

Weve been at the forefront of medicine since 1899. We provide superior healthcare with compassion always mindful that each patient is a person an individual. To accomplish this we need employees with passion talent and commitment with patients and with each other. Were in this together: working to advance medical innovation serve the health needs of the community and move our collective knowledge forward. If youd like to add enriching human life to your profile The University of Chicago Medicine is for you. Here at the forefront were doing work that really matters. Join us. Bring your passion.

Bring your career to the next level at a hospital that is thriving; from patient satisfaction to employee engagement we are at the Forefront of Medicine. Take advantage of all we have to offer and #BringYourPassiontotheForefront.

University of Chicago Medicine is growing; discover how you can be a part of this pursuit of excellence at: University of Chicago Medical Center is an equal opportunity employer. We evaluate qualified applicants without regard to race color ethnicity ancestry sex sexual orientation gender identity marital status civil union status parental status religion national origin age disability veteran status and other legally protected characteristics.