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VCU Health · 2 months ago

Patient Financial Clearance Representative - Adult Outpatient Pavilion - Hybrid

Richmond, VA

Full-time

Hybrid

Mid Level

3+ years exp

VCU Health is seeking a Patient Financial Clearance Representative responsible for financial clearance activities for patients before their appointments. The role involves verifying insurance eligibility, confirming health plan benefits, and communicating patient financial responsibilities to ensure clarity and transparency.

Hospital & Health Care

H1B Sponsor Likely

Responsibilities

Collects and updates patient demographic and insurance plan information

Verifies insurance plan eligibility and benefits using multiple system and web-based tools, as well as calling payer and patient as necessary

Calculates out-of-pocket liability and collects required deposits, co-pays, deductibles and outstanding balances from patient prior to service

Refers patients to financial counselors when assistance needed to identify alternate payer source or establish payment plan

Contacts in-house and community primary care physicians to secure PCP referral for consult and treatment as required by health plan

Contacts health plan to secure prior authorization for procedures/testing as required by health plan

Coordinates peer-to-peer review between VCUHS physicians and health plan medical directors to secure prior authorization for services

Prepares all forms required to obtain payment from third party payer for services

Determines when appropriate to apply additions/revisions to patient account and current visit

Maintains thorough knowledge of commercial, managed care and governmental health care plans

Maintains thorough knowledge of insurance plan authorization and referral requirements

Qualification

Insurance eligibility verificationPatient financial responsibility communicationMedical billing experienceICDCPT codingGE-IDX Patient RegistrationCustomer service skillsMedical terminologyLogical thinkingProblem solving

Required

Minimum three (3) years of previous experience in a health care setting to include: Experience in commercial, managed care and governmental health insurance plans

One (1) year experience in insurance plan authorization and referral requirements; or Medical billing

Previous experience using a personal computer and various software applications, including Microsoft, e-mail, etc

Strong customer service skills and patients/customers centered focus in a positive manner in all situations

High School Diploma or equivalent

Preferred

Previous experience using GE-IDX Patient Registration or other medical billing/registration system

Previous experience in ICD and CPT coding

Previous experience using medical terminology

Post high school education in healthcare or medical billing coursework

Company

VCU Health

Glassdoor3.6

VCU Medical Center is a school. It is a sub-organization of Virginia Commonwealth University.

Founded in 1838

Richmond, Virginia, USA

10001+ employees

https://www.vcuhealth.org

H1B Sponsorship

VCU Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (47)

2024 (32)

2023 (37)

2022 (45)

2021 (44)

2020 (33)