Financial Clearance Representative L2 – OON/Special Coverages

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

📋 Description

• Utilize integrated health information systems and telecommunication technology to enhance customer interactions.

• Accurately search for patients in the EPIC database to minimize duplicate patient records.

• Evaluate patients’ financial capability to pay and refer them to financial counseling when necessary.

• Submit eligibility requests to payors to confirm current coverage.

• Provide clinical, insurance, and demographic details to payors for precertification purposes.

• Verify insurance eligibility using a variety of tools.

• Request and generate referrals for targeted populations.

• Pre-certify services, obtain authorization numbers, and input information into patient accounts using medical, ICD, and CPT codes.

• Contact external entities to validate employment and insurance information for Workers’ Compensation cases.

• Collaborate with the Veterans’ Administration to assure services are covered and authorized.

• Supply accurate information to billing and case management to facilitate claim payment.

• Work in partnership with medical personnel, referring physicians, and designees to gather complete and timely clinical and financial information.

• Uphold confidentiality and adhere to Office of Compliance and HIPAA standards.

• Notify management about system and workflow issues.

• Execute Financial Clearance Representative Pre-Reg responsibilities and assist in that area as assigned.

• Undertake additional duties as assigned.

⛳️ Requirements

• An associate degree or higher, or a high school diploma/GED with 2+ years of experience in insurance, healthcare, or a related field.

• Outstanding customer service abilities.

• Capacity to function in a fast-paced environment.

• Excellent verbal and written communication skills.

• Strong interpersonal skills to manage sensitive, confidential situations and build effective working relationships.

• Commitment to attendance, punctuality, professionalism, attention to detail, cooperativeness, and courtesy.

• Ability to escalate issues when necessary.

• Knowledge and comprehension of coding, insurance, and Federal, State, and third-party billing/reimbursement regulations.

• Familiarity with PC applications including MS Office and the Internet.

• Ability to satisfy employer training requirements.

• Must reside in Ohio while working.

🏝️ Benefits

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Health reimbursement accounts.

• Flexible spending accounts.

• Retirement benefits.

• Employee assistance program.

• Paid time off.

• Paid holidays.

• Wellness program.

• Flexible, competitive benefits package.