Financial Clearance & Insurance Verification Specialist

Yale NewHaven Health; New Haven (CT); On-site; USD 52,000 - 76,000; Full time

Job summary

Yale NewHaven Health is seeking a Financial Clearance Specialist to verify insurance benefits for transplant, surgical, chemotherapy, and radiation therapy. You will collaborate with patients and physicians to support the care plan and payer authorizations, ensuring compliance and accuracy across the revenue cycle.

You will use Epic applications to verify coverage, guide patients to available financial assistance, and maintain up-to-date payer requirements while delivering high-quality customer

Qualifications

• High school diploma or GED required with healthcare or business experience preferred.
• Bachelor's degree preferred; professional certifications valued.
• Experience with insurance authorization/verification and revenue cycle functions.
• Certified Medical Assistant (CMS), LPN, or CPC status preferred.
• Strong knowledge of code sets and medical necessity requirements.

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.
• Utilizes Epic applications from booking to obtain procedure codes as needed.
• Maintains professional approach when communicating with patients, coworkers, and payer representatives.
• Contacts patients to gather demographic and insurance information and updates EMR as necessary.
• Performs other duties to support revenue cycle operations.
• Maintains understanding of third-party payer regulations and medical necessity requirements.

Skills

Strong organizational skills

Excellent verbal and written communic

Strong interpersonal skills

Attention to detail

Multitask

Education

High school diploma or GED

Bachelor's degree preferred

CPC, LPN, Pharmacology license or other medical degree preferred

CRCS or equivalent certification within 18 months of hire

CMS, LPN, or CPC status preferred

Tools

Epic applications

Microsoft Office

Excel

Job description

Yale NewHaven Health is seeking a Financial Clearance Specialist to verify insurance benefits for transplant, surgical, chemotherapy, and radiation therapy. You will collaborate with patients and physicians to support the care plan and payer authorizations, ensuring compliance and accuracy across the revenue cycle.

You will use Epic applications to verify coverage, guide patients to available financial assistance, and maintain up-to-date payer requirements while delivering high-quality customer