Patient Financial Clearance Representative

Role Overview

• Responsible for the entire scope of financial clearance activities for assigned patients before the scheduled appointment date.
• Confirming completeness of patient registration data, verifying insurance eligibility, confirming health plan benefits, procuring PCP referrals and health plan authorizations.
• Calculating/ collecting patient liability estimate, restricting/redirecting out of network patient, and communicating patient financial responsibility.
• Ensuring patient financial responsibility is communicated with consistency, clarity and transparency to ensure patients understand the cost of services they receive, their insurance coverage and limitations, and their individual responsibility.
• Directly impacting health system goals of streamlining clinical operation work flows as well as improving revenue cycle operations and financial performance.

Requirements

• Minimum three (3) years of previous experience in a health care setting
• Experience in commercial, managed care and governmental health insurance plans
• One (1) year experience in insurance plan authorization and referral requirements; or Medical billing
• Previous experience using a personal computer and various software applications, including Microsoft, e-mail, etc.
• Strong customer service skills and patients/customers centered focus in a positive manner in all situations
• Previous experience using GE-IDX Patient Registration or other medical billing/registration system (preferred)
• Previous experience in ICD and CPT coding (preferred)
• Previous experience using medical terminology (preferred)
• High School Diploma or equivalent (required)
• Post high school education in healthcare or medical billing coursework (preferred)

Benefits

• N/A