Payor Clearance Associate

About the role

Located at 1511 Cabin Branch Drive, Landover, MD 20785, within Department 10119, Kids Are Our Everything. Payor Clearance Associates are members of the Revenue Cycle team dedicated to completing patient access and patient financial workflows related to navigating insurance prior authorization processes for assigned services. They facilitate increasing patient access into the care continuum, decrease payor-related barriers, and increase financial outcomes for scheduled services by working directly with referring physician offices, payers, and patients to ensure full payor clearance prior to the provision of care.

Responsibilities

• Navigate and address any payor COB issues prior to services being rendered to ensure proper claims payments
• Obtain and ensure all authorizations are on file prior to services being rendered
• Work collaboratively with assigned department(s)/service(s) of Children’s National Hospital to ensure all scheduled patients have undergone payor clearance prior to service
• Pre-register patients, verify insurance eligibility and benefits, obtain pre-certification or referral status, and collect patient responsibility amounts for services provided throughout the