Financial Clearance Specialist

📋 Description

• Verify insurance eligibility, benefits, and patient liability to avoid denials or penalties.

• Accurately document insurance and payment information to enhance reimbursement and prevent write-offs.

• Keep current knowledge of insurance plans, contract stipulations, and best practices for insurance verification.

• Confirm and secure benefits coverage with insurance providers and employers, ensuring demographic information is accurate.

• Cross-check Medicare accounts and coordinate benefit statuses as necessary.

• Identify and process pre-certification or referral requirements in accordance with established protocols.

• Communicate with providers about out-of-network challenges and document as needed.

• Estimate and collect patient liabilities prior to service, adhering to cash management policies.

• Maximize collection of co-pays and other outstanding balances in line with department protocols.

• Review and resolve accounts on hold to ensure timely billing processes.

• Collaborate with the Authorization team to secure payer authorizations and referrals.

• Ensure adherence to HIPAA and all regulations pertaining to insurance processes.

• Continuously enhance your skills to stay updated with changes in insurance and reimbursement guidelines.

• Maintain regular and consistent attendance as determined by department leadership.

⛳️ Requirements

• A minimum of 2 years of experience in registration, financial clearance, or patient financial services, with a solid understanding of healthcare insurance.

• Excellent comprehension of insurance coverage, benefit verification, and reimbursement regulations.

• Strong mathematical and analytical abilities.

• Proficient in Microsoft Office Suite and capable of learning new software applications.

• Highly organized, detail-focused, and able to prioritize effectively.

• Exceptional verbal and written communication skills; comfortable engaging with diverse audiences.

• Strong interpersonal skills demonstrating professionalism, tact, and diplomacy.

• Critical thinker; able to work independently as well as collaboratively in a team setting.

• Commitment to confidentiality and teamwork.

• Associate’s or Bachelor’s degree is preferred.

• Experience with managed care coverage, reimbursement, medical terminology, and medical coding is preferred.

🏝️ Benefits

• Opportunities for growth.

• Comprehensive benefits package.

• Opportunity to make a meaningful impact in the lives of those we serve.