• Job Description

  Req#: 3380484
  Job Type
  
  Full-time
  
  Description
  
  GENERAL SUMMARY
  
  The Financial Clearance Specialist is the pre-service contact for patients whose role is to obtain all necessary information to register and financially clear patients before the service date. This role directly impacts the patient's experience by serving as the customer service point of contact pre-service. The Financial Clearance Specialist will be responsible for pre-registration, insurance verification, price estimation, and pre-service patient liability collections
  
  Requirements
  
  ESSENTIAL JOB FUNCTION/COMPETENCIES
  
  Responsibilities include but are not limited to:
  
  
  • Verifies the patient's insurance using RTE (Real Time Eligibility) or by contacting the payer directly via the payer's website or phone call.
  • Verifies negative batch or RTE responses by contacting the payer directly via the payer website or phone call.
  • Obtains accurate and complete information regarding patient benefits, coverage, and eligibility including effective date, coverage limits and in-network status, and out-of-pocket patient amounts.
  • Notifies and collects patient deposit requirements and financial obligations in advance of rendering services.
  • Works exceptions to resolve outstanding eligibility issues including contacting patient to capture accurate insurance information prior to appointment.
  • Collaborates with the Financial Counseling team, understands state policies, and works to improve the ability to correctly identify true self-pay patients or those patients in need of financial counseling.
  • Follows appropriate escalation procedures related to financial clearance not obtained with cross functional teams, including Front Desk, Providers, Administration, etc.
  • Performs other position related duties as assigned.
  • Employees shall adhere to high standards of ethical conduct and will comply with and assist in complying with all applicable laws and regulations. This will include and not be limited to following the Solaris Health Code of Conduct and all Solaris Health and Affiliated Practice policies and procedures; maintaining the confidentiality of patients' protected health information in compliance with the Health Insurance Portability and Accountability Act (HIPAA); immediately reporting any suspected concerns and/or violations to a supervisor and/or the Compliance Department; and the timely completion the Annual Compliance Training.
  
  
  CERTIFICATIONS, LICENSURES OR REGISTRY REQUIREMENTS
  
  KNOWLEDGE | SKILLS | ABILITIES
  
  
  • Demonstrates understanding of business and how actions contribute to company performance.
  • Proven familiarity with eligibility and financial clearance activities.
  • Demonstrates excellent customer service skills.
  • Extensive knowledge of practice management system, Microsoft Office, and other tools as it relates to financial clearance.
  • Excellent time management skills and ability to handle multiple tasks while meeting departmental deadlines.
  • Professional verbal and written communication skills.
  • Well organized with the ability to maintain accuracy and confidentiality.
  • Knowledge of medical terminology, healthcare coding systems, and clinics functions.
  • Excellent verbal and written communication skills.
  • Excellent organizational skills and attention to detail.
  • Strong analytical and problem-solving skills.
  • Skill in using computer programs and applications including Microsoft Office.
  • Ability to work independently and manage deadlines.
  • Complies with HIPAA regulations for patient confidentiality.
  • Complies with all health and safety policies of the organization
  
  
  EDUCATION REQUIREMENTS
  
  
  • High School Diploma or equivalent required.
  
  
  EXPERIENCE REQUIREMENTS
  
  
  • 2+ years experience within a hospital or clinic environment, an insurance company, managed care organization or other financial service setting, performing financial counseling, financial clearance and/or customer service activities.
  • Comprehensive understanding of insurance verification, contract benefits, and medical terminology.
  
  
  REQUIRED TRAVEL
  
  
  • N/A
  
  
  PHYSICAL DEMANDS
  
  Carrying Weight Frequency
  
  1-25 lbs. Frequent from 34% to 66%
  
  26-50 lbs. Occasionally from 2% to 33%
  
  Pushing/Pulling Frequency
  
  1-25 lbs. Seldom, up to 2%
  
  100 + lbs. Seldom, up to 2%
  
  Lifting - Height, Weight Frequency
  
  Floor to Chest, 1 -25 lbs. Occasional: from 2% to 33%
  
  Floor to Chest, 26-50 lbs. Seldom: up to 2%
  
  Floor to Waist, 1-25 lbs. Occasional: from 2% to 33%
  
  Floor to Waist, 26-50 lbs. Seldom: up to 2%

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