Financial Clearance Specialist

Major Responsibilities

• Initiates contact with insurance companies to obtain eligibility, gather accurate patient billing information, and perform collections with outstanding accounts receivable.
• Accurately estimates the patient financial liability (copayments, deductibles, coinsurances, deposits, etc.) via obtaining accurate demographic and financial information.
• Answers patient inquiries regarding their liability and explains the variables involved.
• Receives and processes patient payments.
• Ensures pre-certification authorization and/or referral is in place prior to service being rendered.
• Appropriately refers patients to Financial Counselors or Business Office depending on the patient's need.
• Reschedules appointments when requested by patient or, under advisement of department leader, when due to financial circumstances require postponement.
• Enters clear, concise notes concerning financial clearance status in system based on communications.
• Demonstrate knowledge and understanding of all job-related policies and procedures and adhere to and consistently apply the Financial Clearance Policy in all patient cases.
• Assesses gaps in patient coverage to determine patient financial exposure prior to rendering service.
• Consistently demonstrates ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary.

Position Qualifications

• Preferred: Minimum High School Diploma, or G.E.D., business concentration preferred. Associate degree, or higher, preferred.
• Required: Four plus (4+) years of experience within a business office setting, hospital revenue cycle preferred, Physician office or collection agency. Prior experience in a healthcare environment required.

Physical Demands And Environmental Conditions

• On-the-job time is spent in the following physical activities: Stand - 1/3 Walk - 1/3 Sit - 2/3 Talk or hear - 2/3
• This job requires that weight be lifted, or force be exerted: Up to 10 pounds - 1/3