Financial Clearance Coordinator

Children's Hospital Colorado; Aurora (CO); Hybrid; USD 29,000 - 43,000; Full time

Benefits offered by this job

Annual bonus program

Education benefit

Wellness program

403b employer match

Job summary

Children's Hospital Colorado is seeking a Financial Clearance Coordinator to manage high-risk insurance accounts within the Finance department. You will verify benefits, obtain authorizations, prepare cost estimates, and act as a liaison between families, providers, and insurers to ensure smooth financial clearance for outpatient visits or admissions.

The role involves collaboration across departments, adherence to HIPAA, and helping patients understand benefits and costs.

Qualifications

• High School diploma or GED.
• Minimum 1 year of customer service experience.

Responsibilities

• Secures and completes accounts by verification of benefits, finalizing estimates, notice of admission, and/or obtaining prior authorization as required.
• Notifies insurers of expected services and secures required authorizations.
• Assists in collecting payments prior to services using the cost estimate tool to ensure financial security.

Skills

Customer service

Education

High School diploma or GED

Job description

Job Overview

The Financial Clearance Coordinator manages assigned high-risk insurance accounts within the Finance department. Verifies insurance benefits, obtains authorizations and pre-certifications, performs notice of admissions, and updates cost estimates prior to outpatient visits or scheduled admissions. Serves as a liaison between the family, provider, and insurance company to ensure financial clearance of assigned accounts.

Job Overview

The Financial Clearance Coordinator manages assigned high-risk insurance accounts within the Finance department. Verifies insurance benefits, obtains authorizations and pre-certifications, performs notice of admissions, and updates cost estimates prior to outpatient visits or scheduled admissions. Serves as a liaison between the family, provider, and insurance company to ensure financial clearance of assigned accounts.

Additional Information

Department Name: Insurance Verification

Job Status: Full time, 40 hours per week.

Shift: Monday to Friday 8am to 5pm, Hybrid

Duties & Responsibilities

• Ensures accounts are secured and complete by performing benefit verification, estimate finalization, notice of admission, and/or prior authorization for services. Notifies insurance companies of expected services rendered and secures authorization/pre-certification as per payer requirements.
• Assists in payment collection before services are rendered by utilizing the cost estimate tool to ensure financial security of the organization.
• Navigates hospital account records to identify billed services and how insurance coverage was applied. Resolves errors within accounts regarding eligibility, verification, and authorization to ensure clean claims.
• Collaborates with various departments throughout the organization to ensure accounts are secured prior to date-of-service.
• Ensures patients are informed of benefits and associated costs by creating and communicating personalized estimates of financial responsibility.
• Verifies that required referrals are in place for services to be covered by the payer and verifies policy details including any exclusions the payor may have for expected services rendered.
• Verifies, updates, and edits insurance coverage information for patients.
• Identifies and resolves issues related to insurance information, referrals, and authorizations promptly. Coordinates with families, clinics, and referring providers to ensure financial security of encounters.
• Utilizes payer portals, automation, and relevant systems to secure financial aspects of accounts.
• Participates in peer development programs and serves as a resource for co-workers and staff.
• Adheres to HIPAA regulations and appropriately documents all contacts within PHI-secured systems.
• Assists patients, families, providers, and staff with insurance or cost estimate-related inquiries and escalations, and self-pay estimates for those without coverage or for non-covered services. Responds to inquiries about anticipated costs, calculate balances based on coverage and benefits, coordinate with clinics and families.

Minimum Qualifications

• Degrees
• High School diploma or GED
• Experience
• Minimum Experience Required:One (1) year of customer service experience.

Salary Information

Pay is dependent on applicant's relevant experience.

Hourly Range: $20.74 to $31.11

Benefits Information

Here, you matter. As a Children’s Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development tools, including an education benefit to help you advance your career.

As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April.

Children’s Colorado delivers annual base pay increases to eligible team members based on their performance over the previous year.

EEO Statement

It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information. The position is expected to stay open until the posted close date.

Colorado Residents: In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of attendance at or graduation from an educational institution. You will not be penalized for redacting or removing this information.