Financial Clearance Specialist III

About the role

Under the general direction of a supervisor or manager, you will perform pre-registration functions and obtain authorizations from various insurance carriers. This role requires a high level of independent judgement to coordinate and obtain authorization requests for complex managed care patients in a timely and efficient manner. You will utilize telecommunications and computer information systems to pre-register patients, verify information and insurance, and obtain authorizations.

The Financial Clearance Specialist is a highly independent and flexible resource focusing on system-specific service lines aligned with the patient experience initiative. You will multi-task between different patient care areas to ensure an extraordinary patient experience and that quality standards are met.

Responsibilities

• Perform pre-registration and obtain authorizations from insurance carriers
• Coordinate and obtain authorization requests for complex managed care patients
• Utilize telecommunications and computer systems to verify patient information and insurance
• Communicate with physicians and patients as an information resource
• Manage incoming/outgoing faxes, organize and file departmental documents, and perform data entry
• Answer and make phone calls related to departmental duties
• Submit and review chemotherapy and episode-based medication authorizations, including treatment plan and clinical documentation review
• Perform insurance and benefit verification
• Work with major insurance plan web portals
• Maintain thorough knowledge of department policies, procedures, and standards
• Ensure productivity and accuracy based on department standards

Requirements

• Three years of health insurance experience, with authorization experience required
• Experience with electronic medical records, medical terminology, CPT codes, and ICD-10 codes
• At least two years of front desk oncology practice experience registering patients
• Recent Epic EMR experience
• Strong background in submitting and reviewing chemotherapy and episode-based medication authorizations
• Experience with insurance and benefit verification
• Proficiency with Microsoft Teams, Outlook, Excel, and Adobe Acrobat Pro
• Chemotherapy authorization experience (preferred)
• Must be based on the West Coast

Qualifications

• High School Diploma
• Three years of related healthcare authorization, pre-registration, insurance verification, or referral experience
• Medical terminology and electronic medical record experience

Schedule

8:30 AM – 5:00 PM, hybrid work from home and office rotation (all training is on-site at the Irwindale location).

FTE conversion or extension is possible. Interviews will be conducted via Teams.