A key member of the outpatient team that initiates and coordinates patient flow prior to the date of service. Maintains positive communications through direct interactions with the medical staff, their office personnel, the clinical team and leadership, utilization management, and other hospital departments. Highly accountable for the maintenance of revenue cycle operations within the service line to maximize program utilization and overall reimbursement.
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Customer Service
· Establishes and maintains productive, professional relationships with patients and team members.
· Proactively assesses, clarifies, and validates patient and family needs on an ongoing basis.
· Maintains friendly and courteous interpersonal communications, attempting to meet clinical team and provider scheduling needs whenever possible, providing alternative times when preferences cannot be met.
· Completes all patient registration for group and individual programming.
Schedule Management
· Allocates time to clinical team members based on established blocks, first come/first served, available resources, and scheduling policies.
· Incorporates approved criteria for management of program waiting list and scheduling needs of the program.
· Communicates with leadership and clinical teams when changes/adjustments need to be made to program schedules to accommodate the needs of patients and families.
· Coordinates with other departments (inpatient behavioral health, urgent care, ED, etc) to incorporate efficient use of resources into the schedule.
· Verifies preliminary schedules on a daily basis to ensure accuracy and completeness, preventing errors that could potentially cause delays or cancellations.
· Maintains an open communication chain with clinical team and follows up on scheduled cases as necessary.
Revenue Cycle Management
· Accurately submits charges for services within the required time frame.
· Contacts clinical team and/or leadership when documentation required for billing is missing or incomplete.
· Collaborates daily with the utilization management team to ensure patients are scheduled with the appropriate verbiage, instructions and discharge information to avoid delays or denials in payments.
· Continuously makes necessary process changes based on information from the utilization management team to ensure timely and maximum reimbursement.
· Works closely with leadership and clinical team to ensure patient billing processes are followed by the clinical team.
· Matches patient charges to each service provided to ensure accuracy and maximum financial reimbursement.
Education: High School Diploma. One year post-secondary schooling in related field or direct and applicable work experience. Associates degree in related field or direct and applicable work experience preferred.
Experience: Minimum of two years in an office setting/health related field preferred.
License(s)/Certification(s): Certified Revenue Cycle Representative (CRCR) preferred.
Knowledge/Skills/Abilities: Writes, reads, comprehends and speaks fluent English. Strong customer service orientation/mindset. Critical thinking skills using independent judgment in making decisions. Basic computer knowledge using Microsoft Office, web browser, and email. Knowledge of medical terminology preferred. Knowledge and understanding of hospital revenue cycle preferred.
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