Senior Financial Clearance Specialist

About the role

The Financial Clearance Senior Specialist performs advanced clearance activities for complex cases and serves as a resource for escalated issues. This position ensures adherence to regulatory and payer requirements while supporting revenue cycle objectives through accurate and timely clearance and proactive financial engagement.

Responsibilities

• Conducts detailed reviews of patient accounts to identify and resolve complex insurance issues.
• Addresses high-cost or specialized services requiring advanced knowledge of payer rules.
• Collaborates with clinical and scheduling teams to address barriers impacting clearance.
• Provides training and guidance to less experienced team members on processes and compliance.
• Serves as a subject matter expert for financial clearance processes and creates and updates standard operating procedures to ensure consistency and compliance.
• Maintains awareness of changes in payer requirements and updates internal procedures accordingly.
• Prepares reports on clearance outcomes and trends for leadership review.
• Oversees complex point-of-service collection efforts and initiates outbound calls for high-dollar or escalated financial discussions with patients.

Requirements

• Bachelor's degree in healthcare administration, finance, or related field.
• Minimum of 3 years of experience in healthcare revenue cycle management, preferably in a clearinghouse or similar role.
• Strong knowledge of healthcare regulations and payer policies.
• Excellent communication and problem-solving skills.
• Ability to manage multiple tasks and prioritize responsibilities effectively.
• Proficiency in Microsoft Office Suite, particularly Excel for data analysis.

Qualifications

• Experience with electronic health records (EHR) systems.
• Knowledge of HIPAA and other healthcare privacy regulations.
• Ability to work independently and as part of a team.
• Strong analytical and critical thinking skills.

Skills

• Advanced proficiency in Microsoft Excel and other data analysis tools.
• Strong organizational and attention to detail skills.
• Excellent interpersonal and communication skills.
• Ability to work under pressure and meet deadlines.

Benefits

Join an award-winning company recognized for excellence in healthcare revenue cycle management. Ensemble offers a comprehensive benefits package including healthcare, time off, retirement, and well-being programs. Our culture prioritizes collaboration, growth, and innovation, and we invest in your professional development through certifications and tuition reimbursement. Recognized as a top workplace, we strive to empower our associates to thrive.

Pay

Compensation decisions are based on job-related factors such as geographic location, knowledge, skills, relevant experience, education, licensure, internal equity, and time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.

Schedule

Flexible schedule to accommodate the needs of the position and the individual.