Patient Financial Clearance Specialist

Full-time, on-site position in Gold Beach, OR.

Schedule

• 5×8s (five 8-hour shifts per week)

Pay

Compensation range: $23.58 – $35.67 per hour, based on experience (entry-level through 15+ years). Eligible positions may qualify for additional differentials:

• Licensed Positions:
  • NOC Shift (7:00 PM–7:00 AM): +$3.50/hour
  • Weekend Shift (12:00 AM Saturday–11:59 PM Sunday): +$3.00/hour
• Non-Licensed Positions:
  • NOC Shift (7:00 PM–7:00 AM): +$3.00/hour
  • Weekend Shift (12:00 AM Saturday–11:59 PM Sunday): +$2.00/hour

About the role

Under the direct supervision of the Business Office Manager, the Patient Financial Clearance Specialist coordinates financial clearance for infusion and related services. This position works collaboratively with patients, providers, insurance carriers, Pharmacy, Nursing, Scheduling, Registration, Coding, and Patient Financial Services to verify insurance eligibility and benefits, obtain prior authorizations and referrals, address medical necessity requirements, and identify financial or coverage barriers that could delay care.

Responsibilities

• Coordinates insurance eligibility verification, benefit review, pre-certification, prior authorization, referrals, and medical necessity requirements for infusion and related services.
• Reviews treatment plans and schedules to ensure financial clearance is completed prior to treatment whenever possible and identifies or escalates barriers that may delay patient care.
• Provides financial counseling to patients regarding insurance coverage, anticipated financial responsibility, payment options, and available financial assistance programs.
• Assists patients with financial assistance resources, including hospital charity care, state and federal programs, manufacturer assistance, pharmaceutical grants, free-drug programs, and other available funding options.
• Monitors authorization status, payer requirements, outstanding documentation, and related account activity; follows up on pending, denied, or delayed items and assists with denial resolution as needed.
• Coordinates with providers, Pharmacy, Nursing, Scheduling, Registration, Coding, Patient Financial Services, insurance carriers, and other departments to support timely patient care and accurate reimbursement.
• Maintains accurate documentation and utilizes electronic medical records, payer portals, work queues, and other systems in compliance with HIPAA, regulatory requirements, and Curry Health Network policies.
• Performs other duties as assigned or requested to support the overall needs of the department and in accordance with Curry Health Network’s Mission, Vision and Shared Values.

Requirements

• High school diploma or equivalent required; Associate or Bachelor’s degree in a related field preferred.
• Minimum two (2) years of experience in Patient Financial Services, healthcare revenue cycle, insurance authorization, or a related healthcare environment preferred.

Skills

• Working knowledge of commercial insurance, Medicare, Medicaid, prior authorization, medical necessity, and patient financial responsibility.
• Strong communication, interpersonal, organizational, analytical, and customer service skills.
• Ability to work collaboratively with patients, clinical teams, payers, and revenue cycle departments.
• Computer proficiency, including Microsoft Word, Outlook, Excel, electronic medical records, payer portals, and related healthcare systems.
• Knowledge of HIPAA privacy and security requirements and the ability to maintain confidentiality of Protected Health Information.

Physical Requirements

• Physical Demands:
  • Up to 1/3 of the time: Sit, walk, stand
  • Up to 2/3 of the time and more: Stand, talk or hear, use hands, reach with hands and arms, push or pull, stoop, kneel, crawl
  • Lifting: Up to 10 pounds up to 1/3 of the time
• Vision Requirements: Close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
• Work Environment:
  • Moderate noise level
  • Hearing requirements: Ability to hear alarms on equipment, patient call, and instructions
• Repetitive Motion:
  • From 5–6 hours per day: Fine dexterity
  • From 7+ hours per day: Repetitive use of hands and simple/light grasping