Financial Clearance Specialist

About the role

The Financial Clearance Specialist plays a critical role in the Patient Access team, ensuring patients are financially cleared prior to services. This position serves as a key liaison between patients, providers, insurance carriers, and internal departments to facilitate timely access to care while supporting revenue cycle performance.

Responsibilities

• Verify insurance eligibility, benefits, referrals, and authorization requirements to ensure patients are financially cleared prior to receiving services.
• Obtain, submit, and monitor routine and complex pre-certifications, prior authorizations, and referrals while maintaining accurate documentation.
• Provide patients with benefit information, cost estimates, and financial assistance resources, including collection of applicable patient responsibility amounts.
• Coordinate with physicians, clinical staff, insurance carriers, and ancillary departments to support timely access to care and resolve authorization or scheduling issues.
• Complete patient pre-registration activities, maintain payer notifications, assist with denial prevention efforts, and identify opportunities to improve financial clearance processes.

Requirements

• High School Diploma or equivalent (required).
• Minimum two years of experience in healthcare revenue cycle, medical office, hospital, patient access, or related experience.
• Experience in healthcare registration, scheduling, insurance referral, and authorization processes (preferred).

Skills

• Knowledge of medical and insurance terminology.
• Basic working knowledge of UB04 and Explanation of Benefits (EOB).
• Some knowledge of medical terminology and CPT/ICD-10 coding.
• Knowledge of the Patient Access and hospital billing operations of Epic (preferred).