Financial Clearance Coordinator

Department: Insurance Verification

Job Status: Full time, 40 hours per week. Shift: Day, Monday to Friday, 8:00 AM to 5:00 PM (hybrid).

Responsibilities

• Ensures accounts are secured and complete by performing benefit verification, estimate finalization, notice of admission, and/or prior authorization for services.
• Notifies insurance companies of expected services rendered and secures authorization/pre-certification as per payer requirements.
• Assists in payment collection before services are rendered by utilizing the cost estimate tool to ensure financial security of the organization.
• Navigates hospital account records to identify billed services and how insurance coverage was applied.
• Resolves errors within accounts regarding eligibility, verification, and authorization to ensure clean claims.
• Collaborates with various departments throughout the organization to ensure accounts are secured prior to date-of-service.
• Ensures patients are informed of benefits and associated costs by creating and communicating personalized estimates of financial responsibility.
• Verifies that required referrals are in place for services to be covered by the payer and verifies policy details including any exclusions the payor may have for expected services rendered.
• Verifies, updates, and edits insurance coverage information for patients.
• Identifies and resolves issues related to insurance information, referrals, and authorizations promptly.
• Coordinates with families, clinics, and referring providers to ensure financial security of encounters.
• Utilizes payer portals, automation, and relevant systems to secure financial aspects of accounts.
• Participates in peer development programs and serves as a resource for co-workers and staff.
• Adheres to HIPAA regulations and appropriately documents all contacts within PHI-secured systems.
• Assists patients, families, providers, and staff with insurance or cost estimate-related inquiries and escalations, and self-pay estimates for those without coverage or for non-covered services.
• Responds to inquiries about anticipated costs, calculates balances based on coverage and benefits, and coordinates with clinics and families.

Requirements

• High School diploma or GED.
• Minimum of one (1) year of customer service experience.

Pay

Hourly Range: $19.18 to $28.77 (dependent on applicant's relevant experience).

Benefits

• Competitive base pay and incentives.
• Paid time off.
• Medical, dental, and vision insurance.
• Company-provided life and disability insurance.
• Paid parental leave.
• 403b employer match (retirement savings).
• Robust wellness program.
• Access to professional development tools, including an education benefit.
• Annual employee bonus program based on organizational performance (paid the following April if goals are met).
• Annual base pay increases based on performance.