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U.S. Dermatology Partners · 1 day ago

Patient Financial Clearance Specialist

Tyler, TX

Full-time

Onsite

New Grad, Entry Level

$18/hr - $20/hr

U.S. Dermatology Partners is a healthcare organization focused on dermatology services, and they are seeking a Patient Financial Clearance Specialist. This role involves verifying insurance eligibility and benefits for scheduled patients while maintaining confidentiality and ensuring compliance with company policies.

Health CareHospitalMedicalWellness

H1B Sponsor Likely

Responsibilities

Verify that sufficient information is available for accurate verification and eligibility

Determine if a secondary and/or tertiary insurance should be added to the patient’s account ensuring the appropriate payer is selected for Primary insurance

Accurately ensure coordination of benefits (COB) is calculated and set up accordingly in NextGen

Utilize Rivet, Availity, payer portals and/or contact insurance companies to obtain eligibility, benefits, and/or referral and authorization information

Enter the patient insurance information into NextGen ensuring the selection is the appropriate payer and associated financial class

Follow the Policies and Procedures when accepting Out of Network payers along with notifying the patient immediately

Ensures each patient’s insurance verification is completed and accurate. Document findings in the patient account and contact the patient with either estimated co-insurance, co-pay, and or deductible amounts due on or before the date of service when applicable

Contacts each patient as part of center compliance with CMS Conditions for Coverage guidelines in contacting patients prior to the date of service to review patient’s responsibility

Check insurance company approved procedure lists/medical policies. Notify patient if procedure is not payable and options per USDP’s Self-Pay agreement

Obtain authorizations and/or referrals from insurance companies/physician’s offices. Ensure complete and accurate information is included on the authorization and entered into NextGen

Contact the patient and communicate USDP’s financial policy, when applicable

Resolve Claim Edits associated with authorizations, demographics, and insurance

Track and report trending data associated with claim edits to manager

Work and resolve patient insurance-related tasks. Track repeat tasks and provide to manager

Assist with workflow optimization through piloting new procedures, applications, and policies. Track and report findings to manager

Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service

Performs other duties that may be necessary or in the best interest of the organization

Qualification

Insurance verificationNextGen proficiencyCoordination of benefitsPatient communicationWorkflow optimization

Required

Responsible for the insurance verification of eligibility and benefits for scheduled patients

Follows US Dermatology Partners policies and procedures for insurance verification timeliness and out of network scheduling practices

Maintaining strict confidentiality for all patient accounts

Responsible for short-term and long-term patient financial clearance projects, as assigned

Verify that sufficient information is available for accurate verification and eligibility

Determine if a secondary and/or tertiary insurance should be added to the patient's account ensuring the appropriate payer is selected for Primary insurance

Accurately ensure coordination of benefits (COB) is calculated and set up accordingly in NextGen

Utilize Rivet, Availity, payer portals and/or contact insurance companies to obtain eligibility, benefits, and/or referral and authorization information

Enter the patient insurance information into NextGen ensuring the selection is the appropriate payer and associated financial class

Follow the Policies and Procedures when accepting Out of Network payers along with notifying the patient immediately

Ensures each patient's insurance verification is completed and accurate

Document findings in the patient account and contact the patient with either estimated co-insurance, co-pay, and or deductible amounts due on or before the date of service when applicable

Contacts each patient as part of center compliance with CMS Conditions for Coverage guidelines in contacting patients prior to the date of service to review patient's responsibility

Check insurance company approved procedure lists/medical policies

Notify patient if procedure is not payable and options per USDP's Self-Pay agreement

Obtain authorizations and/or referrals from insurance companies/physician's offices

Ensure complete and accurate information is included on the authorization and entered into NextGen

Contact the patient and communicate USDP's financial policy, when applicable

Resolve Claim Edits associated with authorizations, demographics, and insurance

Track and report trending data associated with claim edits to manager

Work and resolve patient insurance-related tasks

Track repeat tasks and provide to manager

Assist with workflow optimization through piloting new procedures, applications, and policies

Track and report findings to manager

Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service

Performs other duties that may be necessary or in the best interest of the organization

Company

U.S. Dermatology Partners

U.S.Dermatological Partners' integrated care network gives dermatology clinics access to general medical, surgical, and skin treatments.

Founded in 2012

Dallas, Texas, USA

1001-5000 employees

https://www.usdermatologypartners.com

H1B Sponsorship

U.S. Dermatology Partners 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

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Trends of Total Sponsorships

2024 (1)