Financial Clearance Analyst Full Time 40 hours

Bristol Hospital Incorporated; Bristol (CT); On-site; USD 52,000 - 78,000; Full time

Job summary

Bristol Health is seeking a Financial Clearance Analyst to manage pre-service authorizations, verify insurance, and determine medical necessity for services. Working with provider practices and hospital departments, you will ensure timely pre-certifications and accurate records.

You will collaborate with revenue cycle teams, follow payer requirements, respond to inquiries, and support denial management. A bachelor’s degree and revenue cycle experience are preferred; strong communication and

Qualifications

• Bachelor's degree or higher in a related field preferred.
• 1+ year of revenue cycle experience or 2+ years of patient access, financial clearance or financial counselor experience with relevant exposure.
• Knowledge of payer contracts, regulations and guidelines as well as State and Federal laws relating to billing and patient access procedures.

Responsibilities

• Handle authorization process and obtain pre-certification approvals prior to service.
• Submit pre-authorization requests and follow up with payer to ensure timely approvals.
• Maintain accurate records of pre-certifications, approvals and denials.
• Follow up on authorization requests and coordinate with practices and departments.
• Respond to patient and insurance inquiries and provide Good Faith Estimates when required.
• Perform post-service reconciliations and denial follow up tasks.

Skills

Communication

Attention to detail

Problem solving

Teamwork

Organizational skills

Education

Bachelor's degree

Job description

At Bristol Health, we begin each day caring today for your tomorrow. We have been an integral part of our community for the past 100 years. We are dedicated to providing the best possible care and service to our patients, residents and families. We are committed to provide compassionate, quality care at all times and to uphold our values of Communication, Accountability, Respect and Empathy (C.A.R.E.). We are Magnet and received the 2020 Press Ganey Leading Innovator award for our rapid adoption and implementation of healthcare solutions during the COVID-19 pandemic. Use your expertise, compassion, and kindness to transform the patient experience. Make a difference. Make Bristol Health your choice.JOB SUMMARY:Under the direction of the Manager of Pre-Service and Financial Clearance, the Financial Clearance Analyst is responsible for the financial clearance of scheduled patient authorizations, including insurance verification, and validation of medical necessity for services. Works in coordination withprovider practices and hospital departments to ensure all scheduled services are reviewed for required authorizations and cleared in advance. The Financial Clearance Analyst will also work other revenue cycle teams to ensure proper billing requirements are met and denials are proactively addressed.ESSENTIAL JOB FUNCTIONS:Handle authorization process and obtain pre-certification approvals prior to service.Submit pre-authorization requests and follow up with payer to ensure timely approvalsMaintain accurate records and reports of pre-certifications request, approvals, and denialsWork assigned worklists and submit authorization information according to payer requirementsFollow up on authorization requests and coordinate with practices and departments according to established policiesCollaborate with revenue cycle team and participate in monthly meetings to review payment and denial trendsCoordinate with provider practices and hospital departments to ensure timely scheduling of patient proceduresRespond to patient and insurance inquiries and provide Good Faith Estimates when requiredPerform post service reconciliations and denial follow up tasksAct as a back-up to the Financial Counselor team, supporting Notice of Admission and FinancialAssistance activities Adhere to applicable policies and procedures, including HIPAA compliance, and state and federal regulationsOther duties as assignedKNOWLEDGE / SKILLS / ABILITIES:Ability to ensure quality and integrity of assigned tasks and meet given productivity standardsPossess a patient-centric approach to answer questions and provide information in a professional mannerDemonstrate teamwork, cooperation and collaboration within and outside the teamSkill in effective oral, written, and interpersonal communicationSkill in problem-solving in a variety of settings and translation of data into actionable stepsAbility to read, understand, interpret, and analyze payer requirementsAbility to work independently and take initiativeExcellent customer service and communication as well as interpersonal, organizational and analytical skillsDemonstrate initiative and ability to multi-task while working independentlyStrong organizational skills and systems aptitudeREQUIRED EDUCATION / EXPERIENCE:A Bachelor's degree and a minimum of (1) year of revenue cycle experience or Associates degree and a minimum of (2) years of patient access, financial clearance or financial counselor experience or High School Diploma and a minimum of (5) years of patient access, financial clearance or financial counselor experienceExperience with payer portals and requirements preferredFamiliarity with medical and insurance terminologyKnowledge of payer contracts, regulations and guidelines as well as State and Federal laws relating to billing, collections, and patient access proceduresDisclaimerThe above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.