Financial Clearance Center Specialist

Prefer candidate be in Jackson, Mississippi; remote available.

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 or remaining benefits.

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 empowers patients to live with dignity and find fulfillment. For more information, visit www.adorationhealth.com.

Responsibilities

• Verifies eligibility and insurance benefits, including:
  • Confirming the status of used/remaining benefits using electronic and telephonic resources.
  • Communicating 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 conversations with patients, insurance 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 active 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 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 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.