Financial Clearance Specialist - Practice Management - EHT

About the role

AtlantiCare Physician Health Network is seeking an Insurance Verification Specialist. In this role, you will obtain verification of all insurance benefits for patients and maintain/enter that information to reflect the most up-to-date coverage. Your duties may also involve obtaining pre-authorization for services, requiring effective phone communication skills. After verifying coverage, you will determine benefit level coverages and patient financial responsibility. Bilingual communication skills (English/Spanish) are a major plus. Attention to detail is key.

This role requires the use of Cerner/Oracle revenue cycle and practice management modules, along with various additional applications.

Responsibilities

• Verify insurance eligibility for patients and referrals using various verification tools/apps or by contacting the insurance carrier directly.
• Update insurance/benefit information for existing patients.
• Review schedules for upcoming patient appointments.
• Enter new demographics into Cerner.
• Review patient copays/deductibles and enter into the Cerner system.
• Coordinate with front-end staff regarding registration/eligibility errors.
• Enter insurance, referrals, authorizations, and other related patient information into Cerner.
• Answer questions from patients, physician practice staff, and insurance companies.
• Obtain pre-authorization for recommended services and procedures.
• Determine and communicate patient financial responsibilities.
• Communicate and help resolve eligibility and authorization-related denials.
• Manage worklists and queues, as well as eligibility rejection reports.
• Participate in educational activities and attend monthly staff meetings.
• Assist in the development of communication and processes to improve overall departmental performance.

Potential for exposure to bloodborne pathogens and infectious diseases.

Requirements

• High school diploma or GED certificate.
• 1-2 years of relevant experience preferred; medical billing experience is a plus.
• General knowledge of CPT codes and basic medical terminology (preferred).
• Extensive computer/application use and comfort with significant computer work.
• Strong phone communication skills.
• Bilingual ability (English/Spanish) preferred.

Benefits

• Generous Paid Time Off (PTO).
• Medical, prescription drug, dental, and vision insurance.
• Retirement plans with employer contributions.
• Short-term and long-term disability coverage.
• Life and accidental death & dismemberment insurance.
• Tuition reimbursement to support educational goals.
• Flexible Spending Accounts (FSAs) for healthcare and dependent care.
• Wellness programs.
• Voluntary benefits, including pet insurance and more.

Benefits offerings may vary based on position and are subject to eligibility requirements.