Revenue Cycle Associate – Financial Clearance

This is a fully remote position, open to applicants in California, +9 more states.

📋 Description

• Ensure financial clearance through the verification of eligibility and benefits, as well as securing prior authorization prior to the patient’s service date.

• Conduct coverage discovery to uncover additional insurance options when current insurance is inactive.

• Accurately calculate and document estimates of patient liability.

• Provide payers with timely Notices of Admission for inpatient and observation cases, adhering to payer-specific guidelines.

• Validate prior authorization and follow up with providers via phone as necessary.

• Confirm medical necessity and determine when a Medicare Advance Beneficiary Notice of Noncoverage is needed.

• Escalate instances where financial clearance cannot be achieved to the relevant stakeholders.

• Address insurance coverage and authorization discrepancies identified by automated quality assurance tools.

• Manage assigned denials related to referrals, authorizations, notifications, non-coverage, and medical necessity, including coordinating rebills or appeals and acquiring retro authorization.

• Adhere to privacy, safety, and security protocols while properly utilizing equipment and materials.

• Work efficiently and accurately in a remote call center setting, delivering exceptional customer service.

• Engage with providers, payers, patients, and hospital personnel.

⛳️ Requirements

• Proficient typing skills.

• Basic knowledge of medical terminology.

• Effective and professional communication skills in English, both verbal and written.

• Strong critical thinking and problem-solving abilities.

• High school diploma or equivalent.

• Capability to operate within a remote call center environment without distractions or background noise.

• One year of relevant experience in the medical field is preferred.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional growth and career advancement.

• A supportive work atmosphere with a collaborative team.

• Comprehensive healthcare coverage.

• Retirement savings plan.

• Paid time off and flexible scheduling options.

• Student loan repayment assistance.