Senior Financial Analyst at Andersen Consulting reviewing contracts and financial conditions. Collaborating on internal documents and SAP system reporting in a global consulting firm.
About the role
- Financial Clearance Specialist ensuring insurance eligibility for outpatient services at Exeter Hospital. Handling the authorization process and escalating issues for timely resolution.
Responsibilities
- Verifies patient's insurance eligibility for visit, using online tools and by contacting the payer.
- Identifies payer medical necessity determination before services are rendered.
- Determines authorization requirement and obtains authorization from payer.
- Identifies and escalates issues for resolution while communicating with revenue cycle peers and clinical stakeholders.
- Completes assigned work queues and reports daily to achieve productivity standards.
- Follows BIDMC policies and procedures to ensure compliance to regulations.
- Identifies trends and provides periodic reports to departments.
Requirements
- High School diploma or GED required. Associate's degree preferred.
- 1-3 years related work experience required.
- Working knowledge of Common Procedural Terminology (CPT), Health Care Procedural Coding System (HCPCS) coding and International Classification of Diseases (ICD-9, ICD-10).
- Advanced skills with Microsoft applications (Outlook, Word, Excel, PowerPoint or Access).
- Must be able to summarize and communicate in English moderately complex information in varied written formats.
Benefits
- Health insurance
- Paid time off
- Professional development opportunities
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