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Cape Cod Healthcare · 2 hours ago

Financial Clearance Analyst

Massachusetts-Hyannis

Full-time

Onsite

Mid Level

3+ years exp

Cape Cod Healthcare is seeking a Financial Clearance Analyst to enhance their Patient Access department workflows and improve financial clearance processes. The role involves troubleshooting, strategizing for process improvements, and ensuring compliance with insurance verification and prior authorization requirements.

Health Care

Responsibilities

Troubleshoot and evaluate Patient Access department workflows, make recommendations to management, and implement changes

Participate with management in strategizing for Process Improvement initiatives

Attend and participate in management meetings related to oversight of Patient Access Staff and third party vendors

Provide input and feedback for employee evaluations and make recommendations to management for productivity improvement opportunities

Be fully knowledgeable about all aspects of insurance verification and prior authorization requirements

Monitor and track denials originating from patient access and financial clearance areas and look to improve workflows to reduce the volume

Oversees and supports the processes around scheduled patients without insurance coverage in relation to Revenue Cycle operational goals

Perform ongoing Quality Assurance analysis of HB & PB Workqueues with Registration and Authorization owning area. Recommend strategies to deal with problems that get identified during this process and implement agreed upon corrections

Regularly updates knowledge of third party payor regulations, and updates staff in writing of any changes as they become known

Supports the prior authorization workflows and process with knowledge of prior authorization requirements and strategies for obtaining

Responsible for making sure that we stay current on industry changes, adapt our processes to meet these changes and ensure that our Business Office runs smoothly as the result of having finely tuned financial clearance and scheduling processes

Regularly updates knowledge of state and federal regulations to ensure compliance around providing patient estimates

Utilize programs such as Experian OneSource, AIM, Eversource, and individual payer websites to identify and verify insurance coverage for patients

Works in collaboration with other CCH departments to improve the revenue cycle process in an effort to improve processes that enhance service and patient relations

Perform other work related duties as assigned or requested

Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers

Challenges current working practices; identifies process improvement opportunities and presents recommendations and solutions to management. Engages and commits to the organization’s culture of continuous improvement by actively participating, supporting, and promoting CCHC Pillars of Excellence

Qualification

Revenue Cycle experiencePatient Access experienceEpic system proficiencyMS Office expertiseData analysis skillsVerbal communicationWritten communication

Required

Associate degree required, BA or BS desired

Expert computer skills with an emphasis on MS Office programs and data analysis required

Expert verbal and written communication skills are required

Preferred

Minimum of 3 – 5 years' experience in a large hospital's Revenue Cycle and/or Patient Access Department with an emphasis on Scheduling and Financial Clearance strongly preferred

Experience with large hospital information systems is preferred, preferably Epic