Savista · 3 hours ago

Financial Clearance Specialist 1

Remote - USA

Full-time

Remote

Mid Level

$20/hr - $23/hr

3+ years exp

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Responsibilities

Process and verify administrative and financial components of financial clearance including validation of insurance benefits, medical necessity, routine and complex pre-certification, prior-authorization, scheduling and pre-registration, patient benefit and cost estimates, and pre-collection of out-of-pocket cost share.

Obtain pre-certifications, authorizations, and referrals for upcoming appointments.

Communicate recommended changes to schedules and care planning to ensure alignment with authorization requests and payor compliance

Liaison between patient, insurance payors and providers to obtain prior authorization for prescheduled services

Effectively address issues and offer information and support to both patients and physicians concerning financial clearance matters

Process stat request prioritization

Verify demographic information

Apply payor changes to registration

Verify, edit and/or remove user defined referral counts editing final status of referrals

Edit the scheduled date within the referral, pend referrals to any pools, suppressing expiring referrals messages, accessing assigned referral work queues, defer/activate referral work queue items, use referral templates

Apply critical thinking skills to identify and resolve problems proactively

Qualification

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Patient RegistrationInsurance VerificationAuthorizationsMedical TerminologyMicrosoft Office Suite

Required

High School Diploma or equivalent

3+ years’ experience with patient registration in a hospital or physician office, directly with obtaining patient demographic and financial information, handling insurance verification and obtaining authorizations

Proficient with commercial and government insurance plans, payer networks, government resources

Proficient with medical and insurance terminology

Strong customer service skills, including ability to understand, interpret, evaluate, and resolve basic to complex service issues.

Strong attention to detail and accuracy

Excellent verbal and written communication, telephone etiquette, interviewing, and interpersonal skills to interact with peers, management, patients, client, and external agencies

Ability to work with a variety of stakeholders

Proficient in utilizing a variety of computer applications and software, including but not limited to Microsoft Office Suite, Internet Explorer, and other relevant programs

Proven track record in roles that involve managing multiple critical priorities, with a focus on delivering high-quality results and meeting performance metrics.