Financial Clearance Specialist

Financial Clearance Specialist

UMass Memorial Health Care | Worcester, MA, 01601, US
Salary Range:$58,000 – $96,000 Salary range estimated by Zippia

Posted 3 days ago

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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.