Financial Clearance Center Specialist

About the Role

As a Financial Clearance Center (FCC) Specialist, you will contact insurance companies, branch operations, and patients to ensure accurate patient demographic and insurance information, including insurance verification, benefits, and authorizations, as well as the status of used/remaining benefits. Preference given to candidates located in Jackson, Mississippi, though remote work is available.

Responsibilities

• Verifies eligibility and insurance benefits, including confirming the status of used/remaining benefits using electronic and telephonic resources. Communicates identified insurance plans to the billing manager for system updates.
• Obtains pre-certification, authorizations, and referrals to ensure managed care compliance for necessary services.
• Fulfills notification requirements.
• Partners and maintains working relationships with various departments, including Business HUB, Clinical Coordinators, and Branch Operations.
• Provides patient education on topics such as patient rights, regulatory requirements, and financial policies.
• Prepares oral and written communications, including periodic status updates.
• Maintains documentation and notes in the computer system regarding all conversations with patients, insurance company representatives, and pre-certification.
• Supports BrightSpring Health’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FCRA, and other applicable laws.
• Completes all required training, maintains an active working knowledge of BrightSpring Health’s Code of Ethics (LEGACY), and follows reporting procedures related to compliance, incidents, HIPAA, and confidentiality obligations.
• Maintains effective communication strategies and style with patients and insurance companies, both verbally and in writing, to ensure a positive internal and external customer service experience.

Requirements

• High school diploma or GED required; Associate’s Degree or BS/BA from an accredited college preferred.
• 2+ years of experience in a role interfacing with commercial or government insurance payers to verify medical coverage or perform billing, collections, or follow-up activities on covered charges for patients.
• Medical billing certificate or medical insurance specialty certificate preferred.
• Strong analytical skills to process admissions accurately and timely.
• Demonstrated ability to navigate web-based programs and Microsoft Office, including Excel.
• Demonstrated ability to communicate effectively and simplify complex information for all stakeholders in verbal and written form.
• Ability and willingness to work cohesively in a team environment, both locally and across other departments and locations.
• Demonstrated patience with a strong attention to detail.
• Demonstrated ability to apply critical thinking skills, creativity, and a commitment to meeting the needs of stakeholders and patients.
• Minimal travel, rarely or as needed.

About Our Line of Business

Adoration Health, an affiliate of BrightSpring Health Services, provides quality and compassionate services in the comfort of home, supporting patients, families, and caregivers in their time of need. Adoration was formed to fill the need for a loving, community-focused, and caring organization. We empower patients to live with dignity, find a sense of fulfillment, and celebrate with their families a life well-lived. Our employees and caregivers are proud to be part of the Adoration team and the mission of our company.

For more information, please visit www.adorationhealth.com. Follow us on Facebook and LinkedIn.