Financial Clearance Specialist

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

📋 Description

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

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

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

• Submit prior authorization requests for services, tests, and procedures in accordance with payer requirements.

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

• Address denied or delayed authorizations with payers and escalate unresolved issues to the Supervisor when necessary.

• Coordinate with clinical staff to gather and submit essential documentation for authorization approval.

• Notify relevant teams of coverage issues, authorization status, or potential patient financial risks.

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

• Collaborate with schedulers and front-desk teams to ensure appointments comply with insurance requirements.

• Adhere to standardized workflows and documentation protocols as specified by the Supervisor.

• Maintain accuracy and timeliness in financial clearance documentation.

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

• Perform other duties related to the position as assigned.

• Work closely with scheduling, clinical, and billing teams under the direction of the Manager/Supervisor of Financial Clearance.

• Uphold ethical conduct standards and assist in meeting compliance requirements.

⛳️ Requirements

• High School Diploma or equivalent is required.

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

• Understanding of commercial, Medicare, Medicaid, and managed care insurance plans.

• Strong attention to detail and exceptional organizational skills.

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

• Excellent communication and problem-solving skills.

• Professional verbal and written communication abilities.

• Familiarity with medical terminology, healthcare coding systems, and clinic operations.

• Must adhere to applicable laws and regulations, the Solaris Health Code of Conduct, and company policies and procedures.

• Must ensure the confidentiality of patients' protected health information in compliance with HIPAA.

• Must complete Annual Compliance Training.

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

🏝️ Benefits

• Competitive pay.

• PTO.

• Holiday pay.

• Comprehensive benefits package.

• 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.