Financial Services Advocate / Revenue Cycle

At Childrens, the regions only full-service pediatric healthcare center, our people make us the very best for kids. Come cultivate your passion, purpose and professional development in an environment of excellence and inclusion, where team members are supported and deeply valued. Opportunities for career growth abound as we grow our services and spaces, including the cutting-edge Hubbard Center for Children. Join our highly engaged, caring teamand join us in providing brighter, healthier tomorrows for the children we serve.

Children's is committed to diversity and inclusion. We are an equal opportunity employer including veterans and people with disabilities.

A Brief Overview
This position facilitates identification of available coverage and/or financial application process for self-pay patients. Assist's patients, parents, and/or guardians over the phone and in person by exploring financial options and help in completing applications for Nebraska Department of Social Services programs, Marketplace and/or disability as well as internal financial assistance programs. Refers families to appropriate agencies in Nebraska and/or other states for possible assistance.

Essential Functions

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  • Assists patients/parents/guardians with the process of applying for any benefits for which they may be eligible for.
    Meets with families to review statements, payment plan requests, billing disputes, financial assistance, or Medicaid application requests
    Collects on accounts and sets up payment plans
    Coordinates referrals from multiple sources (i.e. Social Work, Revenue Cycle, and Physicians) and counsels patients/parents/guardians in options available to assist them with the payment of their out of pocket costs via Medicaid (including MHCP, Emergency Alien Medical Program, SSI and various waiver programs), health insurance, the Affordable Healthcare Act Marketplace, COBRA, CHIPS, Payment Plans, various health agencies (such as MDA, MS, Prescription Assistance Programs, Chicano Awareness Center, etc.) and/or the Organization's Financial Assistance Program depending on their current income levels.
    Provides Patient Estimates when requested by family, or to be in compliance with the Surprise Billing Act.
    Assists with identification of international patients and reports to Manager Financial Clearance for review.
    Reviews all potential high dollar accounts and meets with families prior to services being rendered.
    Assists with identification of international patients and reports to Supervisor Financial Advocacy for review.
  • Assist with financial determination for families referred by Customer Service or Social Work. Parent or guarantor may also call and request financial assistance.
    Assist with completion of the application
    Assure the family has applied for Medicaid
    Review to make sure all required documentation is received to determine eligibility for financial assistance
    Using the Federal Poverty guidelines and Childrens Nebraska thresholds to determine amount of assistance available
    Communicate approval or denial to family
    Obtain Leadership approvals as needed and enter adjustment into Epic
    Responds to questions relating to billing, insurance, and collection issues from multiple sources in an accurate and timely manner.
    Provides Patient Estimates when requested by family, to be in compliance with the Surprise Billing Act, or when needed as part of Financial Assistance determination
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  • Reviews and works towards resolution on all patient concerns, written and verbal, that cannot be successfully resolved by Registrars, Social Work and other areas throughout the organization.
    Responds accordingly to customer via telephone or letter in a timely manner
    Records and maintains complete, accurate documentation in EPIC of activities performed on all accounts they are responsible for.
    Review with Supervisor Financial Advocacy accounts that cannot be successfully resolved, on a weekly basis, for further direction which may include escalation to Manager and/or Director of Revenue Integrity, providing follow-up until resolution.
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  • Check weekly all pending Medicaid & SSI applications.
    At point of approval update Registration and Visit level in Epic and alert Case Management if patient in-house.
    For denied applications:
    1. Notify Supervisor Financial Advocacy
    2. Determine eligibility for Charity Care or payment options,
    3. Obtain approval from Supervisor to remove Pending Medicaid from all accounts and make all necessary adjustments.
       Performs a monthly check, during the first week of each month, of all in-house Iowa and Nebraska Medicaid patients to determine if they are still eligible for Medicaid and under which plan coverage is in effect for the current month.
       Responsible for updating any coverage change in Epic.
  • Provides updates to Access, Social Work, Case Management and Revenue Cycle as needed for billing, authorization, and discharge planning purposes.

Education Qualifications

• High School Diploma or G.E.D Required and
• Associate's Degree in Billing, Coding, Business, Finance, or related field Preferred

Experience Qualifications

• Minimum four years experience working with patient registration, commercial/government billing and reimbursement processes, or clinical operations Required and
• Previous customer service experience Required

Skills and Abilities

• Knowledge of hospital and professional billing, collection and reimbursement requirements and standard practice.
• Ability to review, interpret and understand managed care contracts with third-party payors.
• Intermediate computer skills including the use of spreadsheet programs and word processing programs.
• Detail oriented and ability to organize, interpret, and present data.
• Ability to successfully interact with a variety of internal and external customers at all levels required.
• Organizational and time management skills to maintain and prioritize daily work and follow-up on accounts in a timely manner required.
• Multi-task oriented and able to function in a constantly changing environment required.
• Ability to solve problems independently and must be strongly vested in team management required.
• Excellent oral and written communication skills as this position will deal directly with the public daily and will also be noting accounts daily that several stakeholders in the organization refer
• to so they can check on status of accounts.

Licenses and Certifications

• Bilingual, Spanish Preferred

Childrens is the very best for kids and the very best for your career! At Childrens, we put YOU first so together, we can improve the life of every child!