Financial Clearance Specialist jobs in United States
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CommonSpirit Health · 11 hours ago

Financial Clearance Specialist

CommonSpirit Health is a leading healthcare organization that focuses on providing innovative clinical care. The Financial Clearance Specialist will analyze financial data, prepare and submit claims to insurance companies, and ensure compliance in financial processes to support the organization's fiscal health.

Health CareMedicalNon Profit

Responsibilities

Prepares and submits claims to various insurance companies either electronically or by paper
Reconciles and ensures all electronic claim files are received and correctly processed by E-commerce and by the payers
Fully researches and performs follow up on any claim or payer edits via ETM views. Maintain productivity percentage at the rate established for the Fiscal Year goal
Acts as a highly skilled specialist and subject matter expert in EDI requirements and submission format
Ensures the accuracy of claims for reimbursement by gathering and processing information needed to complete medical insurance claims
Maintains average QA percentage at the rate established for the Fiscal Year goal

Qualification

Electronic billing processesClaims payment lawsHCFA 1500 billingExcel proficiencyMedical terminologyAnalytical skillsAttention to detailCommunication skillsProblem-solvingTime management

Required

High School Diploma or GED
One (1) year experience in electronic billing processes and proficiency with electronic data applications
Four (4) years physician billing/collection experience or other related healthcare provider claims experience in a high volume medical healthcare claim environment
AHCCCS/ Medicare/government Commercial payer experience
HCFA 1500 billing experience
Must have an aptitude for systems applications and be proficient in Excel and all Google/Microsoft Office products
Must have a working knowledge of claims payment laws, as well as medical terminology
Must be a detail oriented problem-solver with good time management skills and the ability to work independently or as part of a team
In addition to possessing solid office and analytical skills, they must also be effective communicators so that they can resolve issues in a fast-paced environment

Preferred

One (1) year experience in Physician front office to include registering patient demographics and insurance, and verifying eligibility

Company

CommonSpirit Health

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Common Spirit Health is a healthcare organization that provides research programs, home health programs, and virtual care services. It is a sub-organization of CommonSpirit Health.

Funding

Current Stage
Late Stage

Leadership Team

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Wright Lassiter
Chief Executive Officer
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Christine Brocato
System VP, Strategic Innovation
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Company data provided by crunchbase