Responsible for the entire scope of financial clearance activities for assigned patients before the scheduled appointment date. Financial clearance includes, but is not limited to, 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. Ensure 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. Successful performance of job duties directly impacts health system goals of streamlining clinical operation work flows as well as improving revenue cycle operations and financial performance.
Licensure, Certification, or Registration Requirements for Hire:
Licensure, Certification, or Registration Requirements for continued employment:
Minimum three (3) years of previous experience in a health care setting to include:
Experience in commercial, managed care and governmental health insurance plans and
One (1) year experience in insurance plan authorization and referral requirements; or
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
Previous experience in ICD and CPT coding
Previous experience using medical terminology
High School Diploma or equivalent
Post high school education in healthcare or medical billing coursework