Financial Clearance Representative II

This is a fully remote position, open to applicants in United States.

📋 Description

• Secure pre-authorizations for scheduled services and medications that necessitate a moderate degree of clinical expertise.

• Collaborate with both internal and external resources to address authorization situations and verify insurance eligibility and referrals.

• Gather and validate insurance and demographic data.

• Document authorization particulars and accurately update necessary systems.

• Assist with billing-related follow-ups, account modifications, payer requirements, and initial problem resolution.

• Coordinate efforts with billing, admitting, outpatient, patient financial services, utilization review, and other departments.

• Maintain departmental information effectively.

• Identify opportunities for process improvements for management evaluation.

• Aid patients and families in progressing towards scheduled care through precise insurance verification and pre-authorization.

⛳️ Requirements

• High school diploma or equivalent qualification.

• A minimum of 2 years of experience in a related job field.

• Ability to communicate clearly and professionally with families, payers, and internal stakeholders.

• Strong critical thinking skills and the capacity to investigate issues, follow up, and escalate when necessary.

• Excellent organizational skills and meticulous attention to detail.

• Capability to manage work independently in a remote environment.

• Skill in working both autonomously and collaboratively while ensuring accurate documentation and maintaining quality standards.

• Preferred: at least 6 months of experience with insurance authorizations.

• Preferred: background in medical billing, collections on medical claims, or denial follow-up/disputes.

• Preferred: familiarity with medical coding principles, including diagnosis and CPT information.

• Preferred: experience in patient access or similar healthcare revenue cycle roles.

🏝️ Benefits

• Additional compensation may be available, including shift, on-call, or weekend differentials.

• Benefits may be applicable.

• Regular employee status offered.

• Full-time schedule of 40 hours per week.

• Equal opportunity employer.