Senior Financial Clearance Specialist

Role Overview

• Accesses work queues and reports and reviews patient accounts to determine financial clearance status
• Takes action on services without financial clearance
• Ensures demographic and patient contact information is complete and verified
• Verifies guarantor type and information and ensures it is assigned correctly
• Ensures all possible coverages are created and verified
• Collects and validates visit-related registration information
• Verifies Primary Care Physician (PCP) information and ensures appropriate referrals
• Identifies non-covered services and prepares proper Advance Notice Beneficiary (ABN)
• Documents account for registrar action
• Analyzes clinical documentation in support of procedures and submits precertification requests
• Follow up on pending accounts and obtain approvals
• Collaborates with clinical departments for scheduling approved procedures

Requirements

• High School Diploma or equivalent
• At least two years prior experience in a business/health care setting required
• Knowledge of insurance coverage and/or reimbursement required
• Experience providing customer service while processing and verifying electronic demographic, financial or other business-related information and data

Benefits

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