Financial Clearance & Insurance Specialist

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

Job summary

Yale New Haven Health is seeking a Financial Clearance Specialist to verify insurance, obtain authorizations, and guide patients through payer processes in a fast-paced healthcare setting.

The role requires strong organization, communication, and knowledge of medical coding and payer guidelines, with attention to detail and a commitment to excellent customer service. Elevating patient access to care is a core focus.

Qualifications

• High school graduate or GED required with healthcare or business preferred.
• Bachelor's Degree preferred.
• CPC, LPN, Pharmacology License or other medical degree or equivalent preferred.
• CRCS or equivalent certification for Access Professionals required within 18 months of hire.
• CMS, LPN, or CPC status preferred.

Responsibilities

• Verifies patients' insurance and benefits information for transplant, surgical, chemotherapy, and radiation therapy patients.
• Obtains prior authorizations from third-party payers in accordance with payer requirements.
• Maintains professional communication with patients, coworkers, and payer representatives to ensure a positive experience.
• Contacts patients to gather demographic and insurance information and updates the EMR as needed.
• Maintains understanding of third-party payer regulations and medical necessity requirements for specified service lines.

Skills

Organizational skills

Verbal and written communication

Interpersonal skills

Attention to detail

Multitasking

Medical coding knowledge

CPT/HCPCS/ICD coding knowledge

Proficiency in Microsoft Office

Education

High school diploma or GED

Bachelor's degree preferred

Medical credentials: CPC/LPN/CMS or equivalent

CRCS or equivalent certification within 18 months

CPC/LPN/CMS preferred

Tools

Epic EMR

Job description

Yale New Haven Health is seeking a Financial Clearance Specialist to verify insurance, obtain authorizations, and guide patients through payer processes in a fast-paced healthcare setting.

The role requires strong organization, communication, and knowledge of medical coding and payer guidelines, with attention to detail and a commitment to excellent customer service. Elevating patient access to care is a core focus.