Financial Clearance Specialist

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

📋 Description

• Manage and validate administrative and financial aspects of financial clearance, encompassing insurance benefits, medical necessity, pre-certification, prior authorization, scheduling, pre-registration, benefit and cost estimations, and upfront collection of out-of-pocket expenses.

• Acquire pre-certifications, authorizations, and referrals for forthcoming appointments.

• Convey recommended scheduling and care-planning adjustments to ensure alignment with authorization requests and payer compliance.

• Act as a liaison among patients, insurance payors, and providers to secure prior authorization for pre-arranged services.

• Address concerns and offer information and support to both patients and physicians regarding financial clearance.

• Prioritize processing of urgent requests.

• Verify demographic details.

• Implement payer modifications to registration.

• Adjust referral counts and final statuses; modify scheduled referral dates; pend referrals to pools; suppress messages for expiring referrals; access and administer referral work queues; utilize referral templates.

• Employ critical thinking skills to proactively identify and resolve issues.

⛳️ Requirements

• High School Diploma or equivalent.

• Over 3 years of experience in patient registration within a hospital or physician's office, specifically in obtaining patient demographic and financial data, managing insurance verification, and securing authorizations.

• Knowledgeable in commercial and government insurance plans, payer networks, and government resources.

• Familiar with medical and insurance terminology.

• Strong customer service abilities, including the capacity to comprehend, interpret, evaluate, and resolve both basic and complex service issues.

• Exceptional attention to detail and accuracy.

• Excellent verbal and written communication skills, telephone etiquette, interviewing abilities, and interpersonal skills to engage with peers, management, patients, clients, and external organizations.

• Capability to collaborate with a diverse range of stakeholders.

• Proficient in using various computer applications and software, including Microsoft Office Suite, Internet Explorer, and other pertinent programs.

• Demonstrated success in positions that require managing multiple critical priorities, delivering high-quality outcomes, and achieving performance metrics.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and advancement.

• Supportive work environment fostering teamwork and collaboration.