Financial Clearance Specialist, PRN
University of Maryland Medical System · Bel Air, MD · 2 days ago
FinanceFull-time
Key Responsibilities
- Perform insurance eligibility and benefits verification for scheduled and unscheduled services.
- Obtain and document routine and complex pre-certifications, prior authorizations, and referrals required by insurance carriers.
- Review medical necessity requirements and ensure compliance with payer guidelines.
- Monitor and follow up on pending authorization requests to ensure timely approval.
- Cook with and gather documentation necessary for authorization requests.
- Research and resolve authorization, referral, and insurance-related issues that may delay patient services.
Work Experience
- High School Diploma or GED required.
- Minimum of two (2) years of experience in healthcare revenue cycle, patient access, registration, scheduling, medical office, hospital operations, or a related healthcare environment required.
- Experience in healthcare registration, scheduling, insurance referral and authorization processes preferred.
Knowledge, Skills, And Abilities
- Knowledge of medical terminology, insurance terminology, and healthcare reimbursement practices.
- Understanding of commercial, government, and managed care insurance plans.
- Knowledge of authorization, referral, and eligibility verification processes.
- Ability to prioritize multiple tasks and work in a fast-paced environment.
- Basic knowledge of UB-04 billing forms, Explanation of Benefits (EOBs), CPT, ICD-10 coding, and healthcare billing practices.