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UnityPoint Health · 22 hours ago

Financial Clearance Coordinator

Rock Island, IL

Full-time

Hybrid

Entry, Mid Level

2+ years exp

UnityPoint Health is a healthcare organization committed to providing exceptional care. The Financial Clearance Coordinator is responsible for coordinating the financial clearance process, ensuring all services are financially cleared prior to appointments, and serving as a liaison between patients, physicians, and insurance plans.

Health CareHospitalMedical

Responsibilities

Responsible to provide support and knowledge for the financial clearance team members assigned

Assist leadership in recommending, maintaining and approving appropriate staffing levels and administering the following: staff orientations, ongoing education programs, and development courses in all areas of responsibility

Financial Clearance Coordinator will be subject matter expert by assisting with providing oversight, coach and mentor team members, and provides recommendation on workflow

Provides guidance for use of departmental policies, procedures and protocols to evaluate and determine the best alternative for the patient as it pertains to the all aspects of Financial Clearance

Leading all aspects of financial clearance to enable complete, accurate, and timely hospital billing—maximizing collectable and minimizing uncollectible accounts

Maintaining a system of data reporting that provides timely and relevant information to all employees with respect to financial clearance responsibilities

Supervises process of admission notification and informing Utilization Review staff of authorization information to insure timely concurrent review

Ensuring the quality and reliability of Financial Clearance staff

Demonstrates subject matter expertise with insurance requirements

Actively assists department personnel with their duties as time permits or need arises

Readily identifies work that needs to be performed and completes it without needing to be told

Establishes and adheres to customer service standards for the department

Works collaboratively with physician practice personnel as necessary to assure that CPT code is correct for procedure ordered and is authorized when necessary

Initiates pre-certification process with physicians, PHO sites or insurance companies and obtains pre-cert/authorization numbers and other pertinent information that secures reimbursement of account

Completes eligibility check though electronic means or via phone contact with insurance carriers or other agencies and when necessary/requested provide initial clinical documentation

Perform follow-up calls as needed until verification/pre-certification process is complete

Thoroughly documents information and actions in all appropriate computer systems

Works with insurance companies to obtain retroactive authorization when not obtained at time of service

Works with insurance companies, providers, coders and case management to appeal denies claims

Collaborating with the central billing office, medical records, and information systems for all communications and information gathering activities

Follows EMTALA, HIPAA, payer and other regulations and standards

Qualification

Patient access experienceThird-party payer knowledgeVerificationPre-certificationICD coding knowledgeCPT coding knowledgeMedical terminologyInsurance terminologyCustomer serviceCommunication skillsTeam collaboration