Financial Clearance & Authorization Specialist

Yale New Haven Health; New Haven (CT); On-site; USD 55,000 - 75,000; Full time

Job summary

Yale New Haven Health in Connecticut is seeking a Financial Clearance Analyst to manage the financial clearance of complex patient authorizations, verify insurance, estimate prices, and validate medical necessity for services.

You will coordinate patient accounts from scheduling through clearance, interfacing with patients, families, departments and payers to maintain compliance and protect the hospital from financial risk.

Qualifications

• High school graduate or GED with healthcare or business preferred.
• CRCS or equivalent certification for Access Professionals required or in process (within an 18 months of hire).
• Two (2) to three (3) years of work experience with insurance authorization/verification of benefits, revenue cycle functions, hospital/physician offices, or related areas preferred.
• Strong organizational and interpersonal skills; ability to build rapport with a wide variety of individuals.
• Knowledge of payer reimbursement processes and medical terminology.
• Basic understanding of CPT, HCPCS, ICD-9-CM/PCS, and ICD-10-CM/PCS coding; excellent verbal and written communication.

Responsibilities

• Collects, validates and documents patient insurance and benefits information; knowledgeable about all insurance verification requirements.
• Uses On-line Eligibility system and/or other means to obtain benefits and inputs information into Epic; alerts staff of issues as needed.
• Obtains prior authorizations from third-party payers per payer requirements; uses Epic applications.
• Maintains a professional approach in communications with patients, coworkers and payers; supports timely information flow and service quality.
• Participates in ongoing quality improvement efforts within the department; refers issues to appropriate personnel.
• Performs other duties as assigned by Supervisor.

Skills

Insurance verification

Prior authorizations

Epic system

Excel

Communication skills

Education

High school diploma or GED

Associate degree

CRCS certification

Tools

Epic

Microsoft Office

Job description

Yale New Haven Health in Connecticut is seeking a Financial Clearance Analyst to manage the financial clearance of complex patient authorizations, verify insurance, estimate prices, and validate medical necessity for services.

You will coordinate patient accounts from scheduling through clearance, interfacing with patients, families, departments and payers to maintain compliance and protect the hospital from financial risk.