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U.S. Dermatology Partners · 1 day ago

Patient Financial Clearance Specialist (101083)

CORP-Rev Cycle CBO Tyler - Tyler, TX 75701

Full-time

Onsite

Mid Level

$18/hr - $20/hr

3+ years exp

U.S. Dermatology Partners is seeking a Patient Financial Clearance Specialist to manage insurance verification for scheduled patients. The role involves ensuring accurate eligibility and benefits verification, maintaining confidentiality, and handling patient financial clearance projects.

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

Medical insurance verificationNextGenCoordination of BenefitsPCP ReferralPrior AuthorizationAnalytical abilityMicrosoft ExcelMicrosoft WordInterpersonal skillsDetail oriented

Required

3+ years of work experience in medical insurance verification and/or patient financial clearance

3+ years of work experience in PCP Referral and/or Prior Authorization initiation and follow-up

Familiar with individual payer guidelines and the process of collecting in office payments/deductibles/copay/co-insurance

Knowledge of payer contracts including Medicare, Commercial and other government contracts, and guidelines

Detail oriented, professional attitude, reliable

Management and organizational skills to support the leadership of this function

Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations

Ability to work successfully under tight timeframes

Interpersonal skills to support customer service, functional, and team mate support needs

Able to communicate effectively in English, both verbally and in writing

Mathematical and/or analytical ability intermediate to complex problem solving

Intermediate computer operation

Experience with Microsoft Excel and Word

Specialty knowledge of systems relating to job function

Knowledge of state and federal regulations; general understanding of HIPAA guidelines

Preferred

NextGen, Availity and Rivet experience

Knowledge of Coordination of Benefits

Benefits

Medical, Dental, & Vision

401k

PTO & Paid Holidays

Company Paid Life Insurance

Employee Perks Program

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

Represents job field similar to this job

Trends of Total Sponsorships

2024 (1)