Revenue Cycle Specialist – Pre-Encounter Financial Clearance

Role Overview

• Complete all financial clearance activities prior to patient encounters and scheduled procedures
• Verify patient insurance eligibility and benefits prior to scheduled visits and procedures
• Analyze benefit design and determine whether planned services and procedures align with the patient’s benefit design
• Track authorization status and resolve discrepancies prior to date of service
• Document eligibility, benefit analysis, authorizations, and financial clearance activities in practice management and augmented financial systems

Requirements

• High School diploma
• 2–4 years of revenue cycle management or medical financial clearance experience
• Working knowledge of CPT, HCPCS, and ICD-10
• Experience with commercial, Medicare, and Medicaid payers and authorization processes
• Demonstrated ability to research and apply payer policies

Benefits

• Health insurance
• Retirement plans
• Paid time off
• Flexible work arrangements
• Professional development