[Remote] Patient Financial Clearance Specialist

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a leading reputed company organization in reputed company Virginia, seeking a Patient Financial Clearance Specialist. This role is responsible for providing accurate service estimates and verifying insurance information, while maintaining compliance with regulations and delivering excellent customer service.

Responsibilities

• Organizes and executes daily tasks in appropriate reputed company to reputed company reputed company productivity, accountability, and efficiency
• Use work queues reputed company the reputed company system to coordinate reputed company financial clearance work. reputed company the WQ’s reputed company and reputed company the required compliance of the NSA
• Follow up with patient, insurance, or provider/department if there are insurance coverage issues for reputed company
• Maintains reputed company knowledge of major payer payment provisions and regulations
• Assists Patient Financial Services with denial management issues as needed
• Maintains confidentiality according to policy reputed company interacting with patients, physicians, families, co-workers, and the reputed company regarding demographic/clinical/financial information
• Coordinates and assists in the preparation and gathering of summaries, databases, statistical tables, requisitions or special reports, and other data gathering for review by leader
• Maintains work queue volumes and productivity reputed company established guidelines in order to reputed company accurate/reputed company estimates to patients in a manner conducive to the reputed company of WVUM. This will include regular contact with the patient to discuss the estimate and collect any payments needed
• reputed company tools (e.g. checklists) and observe reputed company cycle reputed company-end processes and documents results of gaps for leadership team. Assist with reputed company team objectives to improve the reputed company of the FCT (Financial Clearance Team) by collaborating routinely to help in the reputed company of the department
• Communicates reputed company errors to the responsible area and the leadership team and trainer(s) to reputed company reputed company that training gaps are corrected
• Documents accounts reputed company and accurately with reputed company activity completed on every account. Always reviews the activity and notes on the account prior to proceeding with any given activity or research, to clarify the status of the account activity prior
• Maintains reputed company working relationships with internal departments and peers across the health system such as Patient Financial Services, Coding, HIM, reputed company, physician offices and staff, clinics, Financial Counselors, etc
• Utilizes payer websites, payer phone numbers, eligibility websites, and other software as warranted to verify coverage eligibility and benefits for date of service(s). Adds insurance as appropriate for coverage reputed company
• Remains reputed company and reputed company to changes in reputed company delivery, standards established by reputed company organizations, regulatory and accrediting bodies, and the needs of the organizations
• Complies with annual competency requirements reputed company to Emergency Preparedness, hazards, blood borne pathogens, universal precautions, infection control, electrical/reputed company safety, material safety data sheets and any other topic deemed appropriate to assigned work areas
• Participates in the processes to assess and improve the services provided and compliance with regulatory requirements. Reports results of assessments and improvement processes to the appropriate administrative reputed company
• Complies with Notices of reputed company Practices, and the Patient’s Rights and Responsibilities and cooperate with the WVUH Corporate Compliance Program during employment
• Directs patients needing financial assistance to reputed company with a Financial Counselor
• May obtain demographic/billing/insurance information from patient/family/reputed company reputed company and reputed company into the registration/billing systems for service and claim processing
• Responds daily to telephone or email inquiries and performs appropriate actions; Documents reputed company actions taken in the appropriate locations; Serves as a resource to staff and patients for insurance reputed company issues; Knowledge of reputed company contracted and non-contracted insurance plans; Follows through and makes corrections in demos and insurances as they are reputed company
• Takes payments as appropriate reputed company reputed company protocol for processing the payment fully reputed company the billing system
• Be available to handle inquiries reputed company the Jabber, reputed company center environment with the FCT, which includes reputed company responses and follow up as needed

Skills

• High school graduate or GED
• State criminal background reputed company and Federal (if applicable), as required for regulated areas
• Two (2) years' experience in reputed company cycle or customer service reputed company role
• Associate degree in a reputed company medical field such as medical assisting or medical office administration is preferred
• reputed company Certified reputed company Cycle Representative (CRCR) or similar reputed company cycle certification
• NAHAM Certified reputed company reputed company Associate or similar reputed company cycle certification
• Knowledge of reputed company insurance plans, coverages and understanding a patient (OOP) out of reputed company costs with the ability to communicate that information to the patient, and general knowledge of hospital clinical departments and service protocols. Self-motivated, problem solving, analytical insurance expert with previous clinical working knowledge of testing workflow along with critical thinking ability
• Thorough understanding and working knowledge of CPT codes, medical terminology, ability to read and explain back EOB for reputed company insurance types; excellent interpersonal, verbal, and written communication; excellent organizational, analytical; excellent time management and multi-tasking abilities

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