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Children's Hospital Colorado · 1 day ago

Financial Clearance Coordinator Sr

Aurora, CO

Full-time

Hybrid

Mid, Senior Level

$21.14/hr - $31.72/hr

2+ years exp

Children's Hospital Colorado is a healthcare organization focused on providing quality care to children. The Financial Clearance Coordinator Sr manages high-risk insurance accounts, verifies benefits, obtains authorizations, and serves as a liaison between families, providers, and insurance companies to ensure financial clearance of accounts.

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Responsibilities

Serves as a subject matter expert in finance area by participates in large scale projects and meetings, serves as technical lead, trains specific team members and delegates specific high-risk accounts

Assists in payment collection before services are rendered by utilizing the cost estimate tool to ensure financial security of the organization

Navigates hospital account records to identify billed services and how insurance coverage was applied. Resolves errors within accounts regarding eligibility, verification, and authorization to ensure clean claims

Collaborates with various departments throughout the organization to ensure accounts are secured prior to date-of-service

Ensures accounts are secured and complete by performing benefit verification, estimate finalization, notice of admission, and/or prior authorization for services. Notifies insurance companies of expected services rendered and secures authorization/pre-certification as per payer requirements

Ensures patients are informed of benefits and associated costs by creating and communicating personalized estimates of financial responsibility. Verifies, updates, and edits insurance coverage information for patients

Verifies that required referrals are in place for services to be covered by the payer and verifies policy details including any exclusions the payor may have for expected services rendered

Identifies and resolves issues related to insurance information, referrals, and authorizations promptly. Coordinates with families, clinics, and referring providers to ensure financial security of encounters

Utilizes payer portals, automation, and relevant systems to secure financial aspects of accounts

Participates in peer development programs and serves as a resource for co-workers and staff

Adheres to HIPAA regulations and appropriately documents all contacts within PHI-secured systems

Assists patients, families, providers, and staff with insurance or cost estimate-related inquiries and escalations, and self-pay estimates for those without coverage or for non-covered services. Responds to inquiries about anticipated costs, calculate balances based on coverage and benefits, coordinate with clinics and families