Financial Clearance Specialist
UMass Memorial Health Care | Worcester, MA, 01601, USSalary Range:$58,000 – $96,000 Salary range estimated by Zippia
Posted 3 days ago
Description
Requisition #: 235311
Title: Financial Clearance Specialist
Department: Financial Clearance
Location: UMass Memorial Medical Center
Grade: ADM6
Posting Date: 1/11/23
Shift: Days
Status: Non-Exempt
Union: SHARE
Hours: 40
Shift Length: 8AM-4:30PM
Position Summary:
The role of the Financial Clearance Specialist is to perform a variety of complex duties utilizing insurance and payor knowledge to generate and/or obtain the required insurance referrals and/or authorizations for urgent/emergent inpatient visits, scheduled outpatient procedures and testing prior to services being rendered and/or the release of a claim to the insurance company.
Major Responsibilities:
* Verifies insurance eligibility and coverage utilizing available technologies, payor websites, or by phone contact with third party payors.
* Performs updates and corrections to patient demographic and insurance information.
* Resolves claim edits and stop bills.
* Notifies insurance carriers of all inpatient admissions following payer guidelines.
* Follows up on all surgeries, inpatient and NICU admissions until final authorization is secured.
Position Qualifications:
License/Certification/Education:
Required:
* High school diploma.
Preferred:
* Associates Degree in business or healthcare-related field.
Experience/Skills:
Required:
* English speaking, reading and writing skills.
* Strong intrapersonal and communication skills.
Preferred:
* Previous authorization, insurance referral, and telephone customer service experience.
* Previous experience in a health care organization.
* Bilingual speaking, reading, and writing skills.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
Title: Financial Clearance Specialist
Department: Financial Clearance
Location: UMass Memorial Medical Center
Grade: ADM6
Posting Date: 1/11/23
Shift: Days
Status: Non-Exempt
Union: SHARE
Hours: 40
Shift Length: 8AM-4:30PM
Position Summary:
The role of the Financial Clearance Specialist is to perform a variety of complex duties utilizing insurance and payor knowledge to generate and/or obtain the required insurance referrals and/or authorizations for urgent/emergent inpatient visits, scheduled outpatient procedures and testing prior to services being rendered and/or the release of a claim to the insurance company.
Major Responsibilities:
* Verifies insurance eligibility and coverage utilizing available technologies, payor websites, or by phone contact with third party payors.
* Performs updates and corrections to patient demographic and insurance information.
* Resolves claim edits and stop bills.
* Notifies insurance carriers of all inpatient admissions following payer guidelines.
* Follows up on all surgeries, inpatient and NICU admissions until final authorization is secured.
Position Qualifications:
License/Certification/Education:
Required:
* High school diploma.
Preferred:
* Associates Degree in business or healthcare-related field.
Experience/Skills:
Required:
* English speaking, reading and writing skills.
* Strong intrapersonal and communication skills.
Preferred:
* Previous authorization, insurance referral, and telephone customer service experience.
* Previous experience in a health care organization.
* Bilingual speaking, reading, and writing skills.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
