Financial Clearance Specialist

About the role

Reporting to the Senior Billing Manager, the Verification and Authorization Specialist will have prior medical insurance experience. This role supports Ascend Vision Partners' mission to provide quality, accessible, and patient-centered eye care by ensuring accurate insurance verification and authorization processes.

Team members are expected to exhibit continuous professionalism, including acting with integrity and accountability, supporting clinicians in patient care delivery, fostering a culture of respect, diversity, and inclusion, and enhancing patient access to primary and specialty eye care.

Responsibilities

• Maintains patient demographic information and data collection systems.
• Verifies insurance eligibility for both medical and vision insurances for upcoming appointments using workflow tools, online websites, or direct carrier contact.
• Obtains referrals from the PCP or authorizations from insurance prior to appointments.
• Communicates consistently with patients regarding the status of referrals, authorizations, or requests for updated benefit coverage prior to appointments.
• Reviews patient deductibles and/or copays and documents them in notes sections and billing system pop-ups.
• Assists front desk and call center staff in understanding verification of eligibility or status of referrals/authorizations.
• Collects patient copays, deductibles, and other out-of-pocket responsibilities prior to appointments and/or surgeries/procedures.
• Verifies accuracy of referrals/authorizations and enters them into Managed Visits.
• Participates in the development of organizational procedures and updates to forms and manuals.
• Answers questions from patients, clerical staff, and insurance companies.
• Works with front desk staff and surgical schedulers to ensure clean billing.

Requirements

• Minimum of 1 year of relevant insurance verification and authorization experience and/or training in a physician office, or equivalent combination of education and experience.
• Proficient in computers, relevant software applications, and practice management technology.
• Strong problem-solving skills and sound judgment.
• Ability to collaborate across departments and build effective relationships with internal and external customers.
• Knowledge of customer service principles and practices.
• Ability to achieve team goals while demonstrating organizational values and utilizing resources responsibly.
• Proactive and takes initiative.
• High level of quality through attention to detail and monitoring work.
• Strong organizational skills.
• Excellent verbal, written, and interpersonal communication skills.
• Ability to work independently on assigned tasks and accept direction on given assignments.
• Handles confidential information and/or issues with discretion and judgment.

Work Environment & Physical Demands

Work is performed in an office setting. Physical demands include sitting, standing, walking, typing, phone communication, and face-to-face conversation.