Financial Clearance Specialist

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

📋 Description

• Verify insurance coverage and benefits information through payer portals, clearinghouses, and direct communication with insurers.

• Confirm plan status, effective dates, co-pays, deductibles, coinsurance, and authorization requirements.

• Accurately document verification results in the EHR and/or PM systems.

• Submit prior authorization requests for services, tests, and procedures.

• Monitor and follow up on pending authorizations to prevent delays in patient care.

• Address denied or delayed authorizations and escalate unresolved issues to the Supervisor.

• Collaborate with clinical staff to collect and submit documentation necessary for authorization approval.

• Inform relevant teams about coverage issues, authorization status, or potential patient financial risks.

• Communicate with patients regarding their insurance coverage, financial responsibilities, and outcomes of authorizations.

• Work together with schedulers and front-desk teams to ensure appointments align with insurance requirements.

• Adhere to standardized workflows and documentation protocols.

• Maintain precise and timely financial clearance documentation.

• Participate in daily team huddles and initiatives aimed at process improvement.

• Uphold ethical conduct, relevant laws, regulations, the Solaris Health Code of Conduct, and organizational policies.

• Ensure confidentiality of protected health information in accordance with HIPAA regulations.

• Report any suspected concerns or violations and complete the Annual Compliance Training.

• Perform additional duties related to the position as assigned.

⛳️ Requirements

• A High School Diploma or equivalent is mandatory.

• An Associate’s degree in healthcare, business, or a related field is preferred.

• 1–3 years of experience in insurance verification, medical authorizations, or revenue cycle operations is required.

• Familiarity with commercial, Medicare, Medicaid, and managed care insurance plans is essential.

• Proficiency in EHR systems, payer portals, and Microsoft Office applications.

• Understanding of medical terminology, healthcare coding systems, and clinic operations.

• Strong attention to detail and excellent organizational skills.

• Exceptional communication and problem-solving skills.

• Professional verbal and written communication abilities.

• Capability to adhere to standardized workflows and documentation protocols.

• Compliance with HIPAA and other relevant laws, regulations, and organizational policies.

• Certifications, licensures, or registry requirements: N/A.

• Required travel: N/A.

🏝️ Benefits

• Competitive pay.

• PTO.

• Holiday pay.

• Health insurance.

• Dental insurance.

• Vision insurance.

• Life Insurance.

• Pet Insurance.

• Health savings account.

• Paid sick time.

• Paid time off.

• Paid holidays.

• Profit sharing.

• Retirement plan.

• No weekends, evenings, or holidays.