• Financial Clearance Specialist

    Job ID
    2018-22265
    Employment Type
    full-time
    Hours Per Week
    40.00
    Onsite Work Schedule Details
    M-F 9-5:30p
    Address
    527 W. South Street
    City
    Woodstock
    State
    IL
  • Overview

    Under the general supervision of the Financial Clearance Center (FCC) Supervisor. Contacts insurance companies, physicians, and patients to ensure that accurate patient demographic and insurance information is collected, and that a financial clearance determination can be made. Informs patients of their rights, financial policies, and collects patient liabilities.  Meets department staffing needs which include weekends and holidays.


    Responsibilities

    • Provides excellent customer service to all parties by responding to customer requests/ issues in a proactive and timely manner.  Displays Centegra Service Excellence standards.  Displays positive intra/ inter-departmental communication skills.
    • Verifying eligibility and benefits using electronic and telephonic resources
    • Obtaining pre-certifications, authorizations, and referrals to ensure managed care compliance for necessary appointments
    • Fulfilling notification requirements for inpatient admits
    • Contacting patients to request and obtain monies due, including monies due from previous visits, and issuing receipts
    • Establishing payment plans for patients unable to pay monies due in full
    • Entering the information gathered into the computer system
    • Performing any other function deemed necessary to perform financial clearance 
    • Applying critical thinking skills to identify and resolve problems proactively to maximize reimbursement
    • Exhausting all alternatives when attempting to make a financial clearance determination
    • Working closely with various departments throughout the health system, including Scheduling / Pre-Registration, Financial Counseling, Registration, Billing, Clinical Staff, and the Payment Discrepancy Unit
    • Identifying and communicating insurance plan updates to Billing Managers for input into the insurance master
    • Providing patient education concerning patient rights, regulatory requirements and financial policies
    • Exchanging necessary information with the physician offices, hospital, nursing homes, and other departments to insure a complete and accurate registration record
    • Preparing oral/ written communications including periodic status reports
    • Answering telephones, handling calls or directing calls to appropriate area. Performing other related clerical duties.
    • Documenting notes in computer system regarding all conversations with patients, insurance company representatives, pre-certification notification representatives, and results of collection efforts.
    • Performing other duties assigned by Supervisor.

     

    Qualifications

    • Read and write, perform arithmetic calculations, and possess excellent interviewing and communication skills. Type 60 wpm and possess computer literacy.
    • Hold high school diploma or equivalent required.
    • Have one year service-related experience required. Three years service-related experience preferred. Approximately one to two years experience registering / billing in a medical setting or insurance claims processing preferred.  Medical terminology and/or insurance terminology preferred.
    • Strong interpersonal skills necessary in order to effectively communicate with all customers (patients, visitors, hospital staff and others). 
    • Ability to handle, diffuse, and resolve difficult situations, including customer complaints.
    • Team oriented to support team members as needed.
    • Flexibility and resiliency to adapt to diverse patient dynamics.
    • Highly motivated and goal-oriented to meet performance requirements, including ability to handle multiple tasks simultaneously and to prioritize worklists appropriately.
    • Strong analytical skills to process admissions and appropriately calculate patient shares.
    • Self-motivated and strong organizational skills; ability to handle multiple tasks.
    • Physical ability to perform functional requirements as detailed.
    • The above is intended to describe the general content of and requirements for the performance of this job.  It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.

    Preferred Skills

    • Some college courses preferred

    About nThrive

    Be Inspired. Ignite Change. Transform Health Care. 

    From Patient-to-PaymentSM, nThrive provides all the technology, advisory expertise, services, analytics and education programs health care organizations need to thrive in the communities they serve. Our colleagues share a united passion to help health care organizations strengthen their financial position, which translates to accessible, quality care for all. This passion fuels our drive to innovate and participate in community outreach through the nThrive CARES program. Our colleagues are encouraged to think differently and empowered to make a lasting impact that ensures our health care providers, and our world, are healthy and productive.

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