Financial Clearance Specialist

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

📋 Description

• Verify insurance coverage and benefit details through payer portals, clearinghouses, and direct communication with insurers.

• Confirm plan status, effective dates, copayments, deductibles, coinsurance, and authorization requirements.

• Accurately record verification results in the Electronic Health Record (EHR) and/or Practice Management (PM) system.

• 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 for authorization approval.

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

• Communicate with patients regarding insurance coverage, financial responsibilities, and authorization results.

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

• Adhere to standardized workflows and documentation protocols.

• Ensure accuracy and timeliness in financial clearance documentation.

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

• Perform additional duties related to the position as assigned.

⛳️ Requirements

• High School Diploma or equivalent is required.

• 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.

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

• Strong attention to detail along with excellent organizational skills.

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

• Exceptional communication and problem-solving skills.

• Professional verbal and written communication abilities.

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

• Must comply with applicable laws, regulations, Solaris Health Code of Conduct, and organizational policies.

• Must maintain confidentiality of patient health information in alignment with HIPAA regulations.

• Completion of Annual Compliance Training is required.

🏝️ Benefits

• Competitive pay.

• Paid Time Off (PTO).

• Holiday pay.

• Comprehensive benefits package.

• Health insurance.

• Dental insurance.

• Vision insurance.

• Life Insurance.

• Pet Insurance.

• Health savings account.

• Paid sick time.

• Paid holidays.

• Profit sharing.

• Retirement plan.

• No weekend, evening, or holiday shifts.