Financial Clearance Associate II

Piedmont Healthcare Inc.; Atlanta (GA); On-site; USD 55,000 - 75,000; Full time

Job summary

Piedmont Healthcare Corporate is seeking a Revenue Cycle professional to manage insurance pre-certifications and authorizations for complex outpatient services. The role requires collaboration with physicians and payer staff to gather necessary data and ensure timely approvals.

Applicants should have 3 years in Revenue Cycle, with Epic experience preferred and a clinical background is advantageous. Monday–Friday shift; multisite hospital system environment.

Qualifications

• 3 years of experience in Revenue Cycle or related healthcare revenue cycle
• Bachelor's degree preferred
• Completion of a medical coder training program preferred
• Experience with Epic and clinical workflows is a plus

Responsibilities

• Contacts insurance companies and other third party payers to determine pre-certification, pre-authorization and/or medical necessity requirements for complex outpatient hospital services and specialized procedures.
• Obtains pre-certification or pre-authorization prior to the scheduled complex service.
• Liaisons with physicians and office staff to obtain demographic, insurance or clinical information.
• Notifies payers of admittance when required.

Skills

Rev Cycle experience

Healthcare knowledge

Clinical awareness

Education

GED

Bachelor's degree

Medical coder training

Tools

Epic

Billing software

Job description

Overview

Experience the advantages of real career change

Join Piedmont to move your career in the right direction. Stay for the diverse teams you'll love, a shared purpose, and schedule flexibility that frees you to live for what matters both in and outside of work. You'll feel valued, motivated to be your best, and recognized for your contributions to exceptional patient outcomes. Piedmont leaders are in your corner, invested in your success. Our wellness programs and comprehensive total benefits and rewards meet your needs today and help you plan for the future.

Responsibilities

Contacts insurance companies and other third party payers to determine pre-certification, pre-authorization and/or medical necessity requirements for complex outpatient hospital services, and specialized procedures (i.e. Recurring Visits, Surgeries, IR). Obtains pre-certification or pre-authorization prior to the scheduled complex service being performed. Liaisons with physicians and physician office staff when needed to obtain additional demographic, insurance or clinical information. Notify payers of admittance if required.

SHIFT: MONDAY - FRIDAY 9:30am - 6:00pm.

Qualifications

Education

• H.S. Diploma or General Education Degree (GED) Required
• Bachelor's Degree from a recognized college or university Preferred
• Completion of medical coder training program Preferred

Work Experience

• 3 years exp in Rev Cycle or related exp in healthcare, with one of those years working specifically within Healthcare Revenue Cycle Required
• 4 years of previous related healthcare Revenue Cycle experience Preferred
• Prior Epic experience Preferred
• Clinical experience (i.e., medical assistant, surgical tech) Preferred

Licenses and Certifications

• None Required
• Certification with Healthcare Financial Management Association Preferred
• Certified Revenue Cycle Representative Preferred

Business Unit : Company Name

Piedmont Healthcare Corporate