University of Maryland Medical System · 4 hours ago
Financial Clearance Specialist
Baltimore, MD
Full-time
Onsite
Entry Level
$18.57/hr - $25.99/hr
2+ years expUniversity of Maryland Charles Regional Medical Center (UM CRMC) is known for its commitment to serving patients and the community through teamwork and collaboration. The Financial Clearance Specialist is responsible for processing patient, insurance, and financial clearance for appointments, including validation of insurance, pre-certification, and scheduling.
Hospital & Health Care
Responsibilities
Processes administrative and financial components of financial clearance including, validation of insurance/benefits, medical necessity validation, routine and complex pre-certification, prior-authorization, scheduling/pre-registration, patient benefit and cost estimates, as well as pre-collection of out of pocket cost share and financial assistance referrals
Initiates and tracks referrals, insurance verification and authorizations for all encounters
Utilizes third party payer websites, real-time eligibility tools, and telephone to retrieve coverage eligibility, authorization requirements and benefit information, including copays and deductibles
Works directly with physician’s office staff to obtain clinical data needed to acquire authorization from carrier
Inputs information online or calls carrier to submit request for authorization; provides clinical back up for test and documents approval or pending status
Identifies issues and problems with referral/insurance verification processes; analyzes current processes and recommends solutions and improvements
Reviews and follows up on pending authorization requests
Coordinates and schedules services with providers and clinics
Researches delays in service and discrepancies of orders
Assists management with denial issues by providing supporting data
Pre-registers patients to obtain demographic and insurance information for registration, insurance verification, authorization, referrals and bill processing
Develops and maintains a working rapport with inter-departmental personnel including ancillary departments, physician offices, and financial services
Assists Medicare patients with the Lifetime Reserve process where applicable
Reviews previous day admissions to ensure payer notification upon observation or admission
Must be willing to travel between facilities as needed (applies to specific UMMS Facilities)
Performs other duties as assigned
Qualification
Required
High School Diploma or equivalent is required
Minimum 2 years of experience in healthcare revenue cycle, medical office, hospital, patient access or related experience
Knowledge of medical and insurance terminology
Knowledge of medical insurance plans, especially manage care plans
Ability to understand, interpret, evaluate, and resolve basic customer service issues
Excellent verbal communication, telephone etiquette, interviewing, and interpersonal skills to interact with peers, superiors, patients, and members of the healthcare team and external agencies
Intermediate analytical skills to resolve problems and provide patient and referring physicians with information and assistance with financial clearance issues
Basic working knowledge of UB04 and Explanation of Benefits (EOB)
Some knowledge of medical terminology and CPT/ICD-10 coding
Demonstrate dependability, critical thinking, and creativity and problem-solving abilities
Preferred
Experience in healthcare registration, scheduling, insurance referral and authorization processes preferred
Knowledge of registration and admitting services, general hospital administrative practices, operational principles, The Joint Commission, federal, state, and legal statutes preferred
Knowledge of the Patient Access and hospital billing operations of Epic preferred
Company
University of Maryland Medical System
The University of Maryland Medical System (UMMS) was created in 1984 when the state-owned University Hospital became a private, nonprofit organization.
10001+ employees
H1B Sponsorship
University of Maryland Medical System 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 (9)
2024 (15)
2023 (18)
2022 (9)
2021 (5)
2020 (1)
Funding
Current Stage
Late StageLeadership Team
Kenneth Kozel
President and CEO
Hank Franey
Executive Vice President and CFO
Recent News
2023-06-30
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