Easter Seals Jobs

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Job Location (Full Address):

601 Elmwood Ave, Rochester, New York, United States of America, 14642

Opening:

Worker Subtype:

Regular

Time Type:

Full time

Scheduled Weekly Hours:

40

Department:

910399 Registration & Insurance Mgmt

Work Shift:

Range:

UR URG 104 H

Compensation Range:

$18.65 - $26.11

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

Responsibilities:

Performs the functions of patient account management for individuals receiving services at SMH. Complete the tasks of insurance verification, obtaining precertification, completing credit statements, making payments plans, requesting deposits, initiating referrals to sponsorship programs. Responsible for knowledge and application of the hospital's financial and credit policies. Coordinates account management through discharge and forwards accounts to the patient accounting office.

This position is a member of a Registration and Insurance Management team which coordinates functions associated with Patient demographic, Guarantor, and Insurance Coverage for UR Medicine. Registration and Insurance Management Specialist requires a broad knowledge base in the rules and regulations of third-party billing and the complexities of multispecialty billing. In addition, this position requires experience among the enterprise billing system; Flowcast/EPIC with a proficient competency level in the use of verification, third party and government billing systems. RIM Specialist completes the task of sending real time eligibility and also reviewing batch file for visit volumes of approximately 300,000 monthly as it relates to verification of insurance which includes but is not limited to demographic, co-pay/deductibles, benefit information, referrals/authorization, PCP information and Self Pay recovery. Responsible for contacting patient/representative regarding registration, insurance coverage or lack of to ensure patient is aware and secure revenue for the URMC enterprise. To pursue Medicaid for the patient the RIM Specialist initiates a referral to Financial Case Management. Responsible for updating Flowcast system edits produced by the GE batch file Epic WQ┐s. This position will be responsible in part for a decrease of rework and enhance revenue of 3-5 million dollars annually. This process promotes an uneventful and seamless arrival process. Additionally, a RIM Specialist's advanced knowledge of insurance and system logic aids in accurate and timely reimbursement of services.

Key Functions and Expected Performances, under the direction of the RIM Director:

• Responsible for pre-verification of insurance five days prior to scheduling appointments, real time verification (urgent care, walk-ins, Emergency, etc.) for URMFG and SMH/HH Outpatient departments. Remains competent with a broad knowledge base of insurance requirements and necessary changes affecting all information systems for Primary Care, hospital-based practices, multi-specialty and SMH/HH Outpatient departments. Understands flow of information between the Central Insurance Verification Unit and URMFG/SMH/HH Outpatient departments; importance of registration accuracy. Ongoing communication with management relating to operational and system issues.

• Responsible for working daily on designated edit reports generated by the GE Eligibility System based upon assignments. Initiates outgoing calls to insurance companies, patients and/or representative regarding insurance coverage or lack of in a timely and customer friendly manner utilizing Strong Commitment values. Ensures Flowcast/Epic is updated relating to insurance, co-pay and primary care physician information prior to patient appointment and/or final bill. Completes online referrals to Financial Case Management for Self-pay patients where appropriate, follows-up with departments and primary care offices to reconcile discrepancies, investigate inaccurate insurance, primary care physician and co-pay information, provides recommendations to Lead CIV Specialist and Manager.

• Third Party Payer resource to departmental staff (Access Specialist, Insurance Collection Specialists, Financial Counselor, etc.) within URMFG/SMH/HH departments. Serves as a front-line problem solver for third party billing requirements. Identifies areas of improvement, notifies Lead CIV Specialist, plan and implements as directed. Understands and adopts the Strong Commitment values and behaviors.

• Attends and actively participates in all meetings including staff meetings, compliance and training sessions, etc. Timely completion of annual health update and mandatory hospital in-service. Understand and follows departmental policies and procedures relating to dress code, vacation/PTO requests and HRMS documentation.

• Updates RIM Unit operational procedures. Performs other related duties as assigned.

Background Expectations:

• Associate Degree and 2 years' experience or equivalent combination of education and experience preferably in a Primary Care Office or SMH Ambulatory Care setting

• Knowledge of Verification, Third Party Payor and Government systems

• Knowledge of Flowcast

• Knowledge of PC functions (Word, Excel, e-mail, Web).

• Excellent organization and problem solving skills

• High professionalism, motivation, interpersonal skills

• Exercises excellent communication skills and customer service skills

• Ability to work in a team setting with all levels of management and staff

• Associates or Bachelors Degree preferred.

EOE Minorities / Females / Protected Veterans / Disabled:

The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.

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Learn. Discover. Heal. Create.

Located in western New York, Rochester is our namesake and our home. One of the world’s leading research universities, Rochester has a long tradition of breaking boundaries—always pushing and questioning, learning and unlearning. We transform ideas into enterprises that create value and make the world ever better.

If you’re looking for a career in higher education or health care, the University of Rochester may offer the perfect opportunity for your background and goals

At the University of Rochester, we commit to diversity, equity, and inclusion and united by a strong commitment to be ever better—Meliora. It is an ideal that informs our shared mission to ensure all members of our community feel safe, respected, included, and valued.