Financial Clearance Specialist

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

📋 Description

• Verify insurance benefits and coverage details through payer portals, clearinghouses, and direct communication with insurance providers

• Confirm the status of plans, effective dates, co-pays, deductibles, coinsurance, and authorization prerequisites

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

• Submit requests for prior authorization related to services, tests, and procedures

• Monitor and follow up on outstanding authorizations

• Address denied or delayed authorizations, escalating unresolved matters to the Supervisor

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

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

• Communicate with patients regarding their insurance coverage, financial obligations, and outcomes of authorization requests

• Work with schedulers and front-desk teams to ensure appointments meet insurance criteria

• Adhere to standardized workflows and documentation standards

• Maintain precision and promptness in financial clearance documentation

• Engage in daily team meetings and initiatives for process enhancement

• Perform other related responsibilities as assigned

• Operate under the supervision of the Manager/Supervisor of Financial Clearance to facilitate timely and efficient patient care

⛳️ Requirements

• High School Diploma or equivalent is necessary

• 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

• Competence in EHR systems, payer portals, and Microsoft Office applications

• Outstanding communication and problem-solving skills

• Professional verbal and written communication abilities

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

• Compliance with applicable laws, regulations, the Solaris Health Code of Conduct, and organizational policies

• Maintenance of patient confidentiality in accordance with HIPAA regulations

• Timely completion of Annual Compliance Training

🏝️ Benefits

• 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

• Fully remote position

• No weekends, no evenings, no holidays