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TriHealth · 2 days ago

Financial Clearance Representative III

Norwood, OH

Full-time

Onsite

Entry, Mid Level

1+ years exp

TriHealth is a healthcare organization focused on serving patients and communities. They are seeking a Financial Clearance Representative III responsible for verifying patient insurance, confirming benefits eligibility, and performing authorization and pre-certification to ensure accurate payment for services rendered.

Health CareService IndustryWellness

Responsibilities

Verifying patient insurance

Confirming benefits eligibility

Performing authorization and pre-certification

Calculating and estimating patient liability

Notification as required by third party coverage providers

Reviewing medical records obtaining information such as diagnosis, prior treatment, sign and symptoms, medication and other medical information to submit requests for authorizations for surgery, testing or treatment

Qualification

Medical TerminologyInsurance VerificationPre-certificationCustomer ServiceAutomated Patient Account SystemsManaged CareInterpersonal CommunicationContinuous Learning

Required

High School Degree in Medical terminology course or equivalent knowledge

Knowledge of Medical Terminology

Insurance vocabulary and processes

Government and Non-government third party benefits and coverage rules

Understanding of the impact financial clearance services has on revenue cycle operations and financial performance

1-2 years experience Customer Service Healthcare Dedication to treating both internal and external constituents as clients and customers Maintaining a flexible customer service approach and orientation that emphasizes service satisfaction and quality

Background in managed care or patient billing

1-2 years experience Technical Healthcare

Must have one year experience in insurance verification or precertification experience

Experience with automated patient account system or online verification systems