Northwestern Medicine · 21 hours ago
Financial Clearance Specialist
541 N. Fairbanks, Chicago, IL
Full-time
Onsite
Entry, Mid Level
$21.29/hr - $25.54/hr
2+ years expNorthwestern Medicine is a leader in the healthcare industry, dedicated to a patient-first approach. The Financial Clearance Specialist is responsible for ensuring that all admissions and scheduled surgeries are financially cleared and that patient information flows smoothly through the revenue cycle while providing exceptional customer service.
Emergency MedicineHealth CareHospitalMedicalNutritionRehabilitation
Responsibilities
Consistently practices Patients First philosophy and adheres to high standards of customer service. This includes setting an example to peers, coworkers, etc. by fostering a team atmosphere
Responds to questions and concerns
Forwards, directs and notifies Team Lead or Operations Coordinator of extraordinary issues as necessary
Maintains patient confidentiality per HIPAA regulations
Provides exceptional customer service to consumers which establish a positive first impression of Northwestern Medicine
Exceeds all consumer requests and alerts management of issues or concerns that require escalation
Correctly identifies and collects patient demographic information in accordance with organization standards
Responds to telephone inquiries and performs appropriate action(s)
Documents all actions taken in the appropriate software applications
Monitors admission/registration and scheduled surgeries flow of patient information through the revenue cycle
Serves as a resource to staff and patients for insurance related issues
Has a strong understanding of Medicare/Medicaid rules and regulations, and managed care products
Is knowledgeable of current contracted and non-contracted healthcare insurance plans
Reviews patient electronic medical record for appropriate diagnosis and pre-treatment rendered
Has thorough understanding and working knowledge of CPT and ICD-10 coding
Consults with physicians and their assistants whenever questions arise to insure timely approvals
Follows through and makes corrections in demographics and insurances as they are discovered
Data entry accuracy is imperative in this position
Monitors Referral In-Basket in EPIC to insure work is consistently completed in a timely manner
This involves watching for future test requests to come due and then pre-authorized within the time frame specified by the insurance carrier and the patient notified
Facilitates the pre-authorization of diagnostic exams, between referring physicians and insurance carriers, through the use of online tools, work lists, and direct phone calls as necessary to ensure maximized patient benefits
Ensures all admissions, scheduled surgeries, and certain outpatient procedures are financially cleared, to allow for maximum and timely reimbursement to the hospital
Interacts with various hospital departments and physicians offices to effectively schedule and direct patients through the NMHC systems in a patient/customer friendly manner
Performs medical necessity checks as necessary for scheduled services, communicates options to patient if appointment fails
Informs patients of any issues with securing the financial account for their encounter and completes out-of-pocket estimations as requested by patients
Provides training and education as needed
Manages work schedule efficiently, completing tasks and assignments on time
Participates in Quality Assurance reviews to insure integrity of patient data information
Uses effective service recovery skills to solve problems or service breakdowns when they occur
Utilizes department and hospital policies and procedures to complete assigned tasks
Performs duties within the regulatory guidelines of the Fair Patient Billing Act and the Fair Debt Collection Act
Other duties as assigned
Communication and Collaboration:
Communicates information to the patient regarding questions about physician referrals, insurance referrals and consultations
Collects authorization numbers in appropriate systems as applicable
Provides professional and constructive environment for communication across units/departments and resolves operational issues
May attend intra/interdepartmental meetings which involve walking within NM Campus
Communicates customer satisfaction issues to appropriate individuals
Demonstrates teamwork by helping co-workers within and across departments
Communicates effectively with others, respects diverse opinions and styles, and acknowledges the assistance and contributions of others
Ensures that outpatient procedures have a valid diagnosis code, and that for Medicare patients, medical necessity has been met
Communicates with physician offices to troubleshoot failing medical necessity for Medicare patients
Contacts patients to notify them of high out-of-pocket liabilities, and to establish/enforce compliance with hospital financial policies
Reviews and analyzes all required demographic, insurance/financial and clinical data procured by patient intake and registration areas necessary to expedite payment on patient accounts
Verifies eligibility and benefit information using on-line programs
Performs pre-certification notification via telephone or electronically and gathers and completes all required documentation for submission to insurance carriers per payor requirements
Participate in researching pre-certification denials including missing authorization, patient pre-certification or referral documentation
Works on denied accounts with ancillary departments, physician and account representatives to gather required information
Cross-training between various departments may take place to insure coverage
Technology:
Utilizes multiple online order retrieval systems to verify or print the patients order
Verifies insurance eligibility and benefit levels through the use of online tools (NDAS, ASF, etc.) or over the phone as necessary
Completes accurate handoff instructions and notes to scheduling staff, by noting appropriately in Epic
Demonstrates ability to use all computer applications efficiently and to the capacity needed in this position
Efficiency, Process Improvement, and Business Growth:
Proactive in preventing issues with patient visit by double checking type of test, preps required, assuring no conflict with other tests, verifying time and location, communicating relevant information and documenting order retrieval in notes for check-in person
Understands minimum data set required for a complete registration, collects and verifies critical data and updates that information into registration system
Understands departmental and individual quality metrics
Proactively analyzes account activity, identifies problems, and initiates appropriate actions/resolutions
Evaluates procedures and suggests improvements to enhance customer service and operational efficiency
Participates in departmental quality improvement activities
Provides ideas and suggestions for process improvements within the department
Monitors registration and scheduling, including insurance verification to insure processing within prescribed quality standards
Adjusts processes as needed to meet standards
Uses organizational and unit/department resources efficiently
Acts as a training resource for new staff and a resource for coworkers, sharing process and workflow information
Qualification
Required
High School Diploma or equivalent
2-3 years previous hospital billing, insurance follow-up, or customer service in a hospital setting
Excellent interpersonal, verbal, and written communication skills
Proficiency in computer data-entry/typing
Excellent verbal and written communication skills
Ability to read, write, and communicate effectively in English
Basic computer skills
Ability to type 40 wpm
Ability to multi-task
Customer service oriented
Excellent organizational, time management, analytical, and problem solving skills
Preferred
Bachelors Degree
Additional language skills
Healthcare finance and/or healthcare insurance experience
Knowledge and experience in a healthcare setting, especially patient scheduling and/or registration
Benefits
Tuition reimbursement
Loan forgiveness
401(k) matching
Lifecycle benefits
Company
Northwestern Medicine
Northwestern Medicine is the collaboration between Northwestern Memorial HealthCare and Northwestern University Feinberg School of Medicine around a strategic vision to transform the future of health care.
10001+ employees
H1B Sponsorship
Northwestern Medicine 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
2025 (75)
2024 (66)
2023 (70)
2022 (78)
2021 (35)
2020 (39)
Funding
Current Stage
Late StageTotal Funding
$25M2018-06-26Grant· $25M
Leadership Team
Howard Chrisman, MD
President and CEO
John A. Orsini, CPA
Senior Vice President and Chief Financial Officer
Recent News
2026-01-13
Near North Health
2025-12-01
Company data provided by crunchbase