Financial Clearance Specialist

Role Overview

• Verifies patient's insurance eligibility for visits
• Identifies payer medical necessity determination before services rendered
• Determines authorization requirement and obtains authorization from payer
• Identifies and escalates issues for resolution
• Completes assigned work queues and reports daily
• Follows policies to ensure compliance
• Identifies trends and provides periodic reports to departments
• Performs other activities as needed

Requirements

• High School diploma or GED required
• 1-3 years related work experience required
• Working knowledge of Common Procedural Terminology (CPT), Health Care Procedural Coding System (HCPCS) coding and International Classification of Diseases (ICD-9, ICD-10)
• Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications

Benefits

• Health insurance
• Paid time off
• Professional development opportunities