Financial Clearance Specialist
Core
Verify patient insurance eligibility, benefits, and financial responsibilities to ensure accurate billing and prevent denials in the healthcare revenue cycle.
Role type
Healthcare revenue cycle financial clearance specialist
Builds
Accurate patient financial accounts and insurance coverage verification
Domain
Healthcare / Insurance / Revenue Cycle
Required skills
Insurance eligibility verification, benefits validation, Medicare account review, pre-certification processing, patient liability estimation, HIPAA compliance, medical terminology knowledge
Preferred skills
Managed care coverage experience, medical coding, medical office operations
Technologies
Microsoft Office
Responsibilities
Verify insurance eligibility and benefits to minimize denials; Confirm benefits with payers and validate demographic information; Review Medicare accounts and coordinate benefit status; Identify and process pre-certification and referral requirements; Communicate with providers regarding out-of-network barriers; Estimate patient financial responsibility and collect co-pays; Review and resolve accounts placed on hold; Collaborate with authorization teams for payer authorizations; Maintain knowledge of insurance plans and regulatory changes; Ensure compliance with HIPAA and organizational procedures.
Seniority
Mid-level, hands-on IC
