Financial Clearance Specialist

Overview

Reporting to the Manager of Financial Clearance, the Financial Clearance Specialist will be responsible for ensuring that financial clearance is obtained prior to services being rendered,
patient experience protocols are followed, and clearance is obtained in a timely manner to reduce related denials.

Responsibilities

• Verifies insurance benefits for all new patients prior to the Initial Evaluation.
• Reverifies benefits as needed due to insurance changes/updates.
• Ensures patient demographics and insurance benefits are entered accurately in the EMR.
• Obtains authorizations for services when required by the insurance plan.
• Ensure authorization details are entered accurately into the EMR.
• Monitors authorizations, visit counts, eligibility status to ensure no loss of revenue due to expired authorizations, exceeded visit counts or ineligibility.

Qualifications

• High school diploma required.
• 1-2 years of financial clearance experience in a medical practice or health care setting preferred but not required.
• Strong computer skills relevant to the position required. Experience using Excel, Power Point and Word required.
• Self-starter who excels in a fast paced, data driven environment and shifting work environment.
• Knowledge of and ability to articulate explanations of Medicare, Medicaid, HIPAA, and other government assistance programs and regulations.
• Ability to effectively incorporate the mission and core values into processes.
• Ability to maintain and convey a positive attitude and customer service approach to program development.

About

Confluent Health, LLC and its affiliates are equal opportunity employers committed to building a diverse and inclusive workforce. We do not discriminate based on race, color, religion, sex, sexual orientation, gender (including pregnancy, childbirth, or related medical conditions), gender identity or expression, national origin, marital status, age, disability, veteran status, or other applicable legally protected characteristics. If you need assistance or would like to request an accommodation due to a disability, please contact us at [email protected].