Hybrid Financial Clearance Specialist

at Trinity Health

• Job title: Financial Clearance Specialist
• Job type: Full Time
• Experience level: Junior, Mid level
• Salary: Not specified
• Degree requirement: High School Diploma
• Location requirements: Hybrid, Boise, United States

About the role

• Financial Clearance Specialist coordinating patient financial information and insurance verification processes. Working remotely while obtaining necessary patient details and supporting financial clearance tasks.

Responsibilities

• Obtain and/or verify demographic, clinical, financial and insurance information in the process of pre-registering and financially clearing patients for service delivery.
• Entry of patient/guarantor information in the patient accounting system.
• Responsible for insurance eligibility/benefit verification, pre-certification/authorization, referral clearance and financial education on designated cases.
• Work concurrently on a variety of tasks/projects in a potentially stressful environment with individuals having diverse personalities and work styles.
• Ensure patient safety by authenticating patient identity throughout all essential functions.
• Maintain a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence.
• Responsible for pre-registering the patient for upcoming visit(s).
• Validates, obtains and enters demographic, clinical, financial, and insurance information into the patient accounting system.
• Performs insurance eligibility/benefit verification, utilizing various mechanisms and documenting information within the patient accounting system.
• Informs patient/guarantor of their liabilities and collects appropriate patient liabilities.
• Calculates patient liabilities and provides financial education, referring the patient to financial counseling, as required.
• Validates medical necessity (LCD/NCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance.
• May serve as relief support, if the work schedule or workload demands assistance to departmental personnel.

Requirements

• High school diploma or equivalent required
• Associate degree preferred
• At least two (2) years of experience in financial clearance
• National certification in HFMA CRCR or NAHAM CHAA required within one (1) year of hire
• Must be proficient in the use of Patient Registration/Patient Accounting systems and related software systems.
• Comprehensive knowledge of financial clearance and insurance verification processes with at least two (2) years of financial clearance experience in an acute care setting.
• Past work experience of at least 2 years within healthcare and/or payer environment performing patient access and/or customer service activities.
• Data entry skills (50-60 keystrokes per minute).

Benefits

• 40 hours per week Monday – Friday during traditional office hours
• Position is remote (work from home); however, there is required in-person training during initial orientation in Boise, ID.