Financial Clearance Specialist

Facility: 141 Longwater Drive, Norwell, MA 02061

Status: Full time, 40 budgeted hours per week, day shift

About the role

Under the direction of the Manager of Patient Access Services, this role is responsible for all pre-certification, eligibility verification, benefits verification, and collection of eligible co-pays.

Responsibilities

• Registration, pre-certification, eligibility verification, benefits verification, and co-pay determination on all accounts
• Ensure accounts are processed with fewer than 5 denials per year
• Determine co-pay, notify patients, and arrange for collection
• Comply with all regulatory agencies (e.g., newborn notification) 100% of the time
• Stay current with internal and external policies and procedures affecting reimbursement
• Write and follow up on appeals for denials
• Provide patients with estimates for self-pay and non-covered services
• Document all actions and transactions clearly on accounts
• Collaborate with case management for patient care
• Defer elective cases based on credit and collections policy
• Manage level-of-care changes to ensure proper reimbursement
• Embrace technological solutions for work processes and practices
• Use department computer programs (Meditech, PICIS, PAssport, web-based programs) and run reports
• Use and update PICIS, Tracker, and Passport programs
• Manage own API (timecard) system
• Utilize the telephone system, including VERA
• Understand processes for computer downtime
• Promote and adhere to credit and collection policy
• Assign and transcribe ICD-9 and CPT codes
• Manage and utilize insurance websites to ensure appropriate notification and referrals
• Foster a “Culture of Safety” through personal ownership and commitment to a safe environment
• Adhere to patient identification policies/procedures and universal precautions
• Understand individual role/responsibility during hospital codes (e.g., Code Green, Code Red)
• Complete NIMS 100 training
• Understand role in department-specific emergency preparedness plans
• Identify correct subscriber information
• Participate in continued learning and utilize new technology and procedures
• Register patients with a 98% accuracy rate

Qualifications

• Strong knowledge of third-party insurance
• Proficiency in medical terminology
• Computer skills, including experience with Meditech, PICIS, PAssport, and web-based programs
• Ability to follow through and troubleshoot
• Attention to detail
• Customer service skills
• Organizational skills
• Ability to work well within a team

Pay

Pay Range: $17.42 - $23.45 per hour

Schedule

Monday through Friday, 8:00 AM - 4:30 PM