ICONMA · 1 day ago
Financial Clearance Specialist
Irwindale, CA
Full-time
Onsite
Entry Level
2+ years expICONMA is a company that provides staffing solutions and is seeking a Financial Clearance Specialist for their Cancer Center client in Irwindale, CA. The role involves coordinating insurance authorizations, pre-registration functions, and ensuring high-quality customer service for patients and families.
Staffing & Recruiting
Responsibilities
Identifies insurance companies requiring prior authorization for services and obtains authorization
Coordinates authorizations for procedures and testing requested by providers for their managed care patient
Reviews charts on outpatients and reports to third party payors
Retrieves chemo/surgery orders from chart, and requesting authorization through the insurance companies
Prepares all forms required by third party payor for treatment authorization requests
Work on all pending utilization review patients, and achieve authorization for the following day
Getting emergent authorizations from walk-in patients
Verifying with the insurance companies and documents what needs to be pre-certified
Educates patient of their insurance policy
Composes letters and memoranda from physician dictation, or verbal direction for submission to insurance companies to obtain authorization or appeal denials
Maintains current records on managed care patients
Keeps Case Managers updated on all BMO and BMT patients
Performs pre-registration functions prior to the patient appointment (including, but not limited to: obtains and/or verifies demographic, clinical, financial, insurance information, service eligibility, consent forms, and patient/guarantor information for pre-registered accounts)
Contacts patients, payers, or other departments to confirm and verify insurance and demographic information
Refers patients to financial counselors to resolve insurance or payments issues
Identifies and resolves issues by working with patients, payors, and/or other Client departments and personnel in a single interaction with the patient
Identifies patients with 'share of cost' or co-payments by performing pricing estimations, and notifies patients of their expected patient liability and financial responsibility
Collects patient/guarantor liabilities and refers patients who are uninsured/underinsured to Financial Counselor for charity, financial assistance or governmental program screening and application processes
Notifies Client contracting department of patients with a non-contracted insurance to prepare a Letter of Agreement (LOA) should patient to pursue services at Client and informs patient of approval status
Performs activities required to financial clearance for all patient types. Frequent communications will occur with patients/family members/guarantors, physicians/office staff, medical center and payors
Ensure a high level of customer service by greeting, being a resource to patients and visitors
Serve as a liaison between patients and support staff. Develop effective relationships with colleague, physicians, providers, leaders and other employees across the organization
Demonstrates genuine interest in helping our patients, providers and other employees by using excellent communication skills, being polite, friendly, patient and calm under pressure
Managing multiple, changing priorities in an effective and organized manger, under stressful demand while maintaining exceptional service
Maintain composure when dealing with difficult situations and responding professionally
Independently recognize a high priority situation, taking appropriate and immediate action
Effectively communicates with service delivery and other departments to resolve issues that impact patient care and escalating issues that cannot be resolved in accordance with departmental guidelines
Answering daily phone calls and pages from doctors, patients, employees and insurance companies
Maintains appropriate level of productivity and accuracy for work performed based on department standards
Maintains thorough knowledge of policies, procedures, and standard work within the department in order to successfully performance duties on a day-to-day basis
Qualification
Required
Ability to recognize and use medical terminology
Excellent oral/written communication, interpersonal, collaborative, analytical and organizational skills
Demonstrated ability to effectively use online systems
Function with minimal supervision with high level of productivity
Foster and promote a positive and professional image
Must be able to foster and maintain sound working relationships
Independently motivated and driven to achieve high goals
Effective use of telecommunications and electronic medical record systems
Seek continuous improvement in knowledge and skills
Demonstrates ability to manage multiple, changing priorities in an effective and organized manner, under stressful demands while maintaining exceptional service
Demonstrated ability to maintain composure when confronted by difficult situations and to respond professionally
Maintains commitment to our extraordinary patient care standards and guidelines
Interpersonal/human relations skills
Strong knowledge of PC, phone systems and technology
Readily accepts work assignments and changes in a positive manner
Skill in recognizing an emergency or high priority situation, taking appropriate and immediate action
Microsoft Word and Outlook
EMRs – Allscripts, Touchworks and EPIC
Telecommunications – Avaya phone system
Customer Relationship Management - Salesforce
Preferred
EPIC EMR
At least two years front desk oncology practice experience registering patients and scheduling appointments
Bilingual preferred
Benefits
Health Benefits
Referral Program
Company
ICONMA
ICONMA: Your Partner in Global Staffing Solutions and Digital Transformation ICONMA is a globally recognized, Woman-Owned staff augmentation and technology consulting firm.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Claudine George
Founder and CEO of ICONMA, LLC
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