Location: Chicago, IL

Hospital: RUSH University Medical Center

Department: SBO Enterprise Services

Work Type: Full Time (Total FTE between 0.9 and 1.0)

Shift: Shift 1

Work Schedule: 8 Hr (7:00:00 AM - 3:00:00 PM)

Summary:
Under general supervision, the Financial Specialist is responsible for analyzing and guiding financial and operational activities within the department. The position will have an active role in monthly reporting and analysis, ad hoc reporting, budgeting, forecasting and projections. The Financial Specialist must gather financial information, analyze the information, and use that information to provide clients with recommendations for improving processes and services. Exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.

• Owner of multiple EPIC professional and hospital reimbursement variance account work queues (i.e. overpaid, underpaid, credit balances, A/R account maintenance, etc.), and responsible for analyzing the qualifying accounts and taking corrective action to process all levels of variances before completing the account from a work queue

• Creates and analyzes scheduled professional and hospital financial reporting for underpaid, overpaid, staff productivity, and other financial metrics requested by management to provide meaningful insights on trends and reduce reimbursement variances

• Knowledgeable on obtaining pertinent payment back-up information for account level reimbursement variances, such as payor correspondence and reimbursement calculation sheets

• Identifies if insurance coverage is incorrect and takes the proper action to correct it when necessary

• Performs research on reimbursement variance trends and reports specifics to management

• Collaborates with the team in developing new ideas resulting in improvements to existing workflows

• Assists management in developing, maintaining, and distributing ad-hoc reports as needed

• Maintains knowledge of current, new, and terminated payor contracts while communicating such updates to peers and management

• Maintains open lines of communication with payors regarding reimbursement variances such as refund requests and/or underpayment • Prioritizes proper and detailed documentation in Epic related to all actions taken on accounts

• Ensures the protection of patient private health and personal information, including financial and non-financial information

• Participates in ad hoc projects and other duties as assigned by management

• Collaborates with other revenue cycle departments and physician offices when needed

• Adheres to all federal and state compliance regulations • Completes Rush Corporate Compliance Training (yearly)

Knowledge, Skills, and Abilities:

• Bachelor's degree, Accounting, Finance, or related field

• Detail oriented, organized and ability to multi-task

• Demonstrated working knowledge of physician and hospital appeals, underpayment/overpayment disputes, and payor contract management

• Knowledge of EPIC applications preferred

• Understanding of how to clearly identify physician and hospital payments as: underpaid, overpaid, denied, or paid per contract terms

• Proficient in MS Office Suite products • Analytical skills essential for calculating contractual reimbursement and determining if the physician and hospital has been paid per contract terms

• Demonstrates resourcefulness while performing day to day job duties along with being able to adapt to changing situations with ease and speed

• Ability to observe and analyze payment trends, determine root cause of errors, and report specifics to management

• Ability to work as part of a team to collectively reach team goals • Ability to analyze explanation of benefits for commercial and government payors

• Must be able to work independently with a high degree of accuracy

• Strong interpersonal skills are required for communication of finance-related issues to management and ancillary departments

• Participation in training sessions to maintain awareness and knowledge of evolving heath care policy changes

Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.