Financial Clearance Representative III

TriHealth; Cincinnati (OH); Remote; USD 35,000 - 45,000; Full time

Job summary

TriHealth is seeking a Financial Clearance Representative III to ensure accurate patient insurance information and facilitate payment for services. This remote position requires knowledge of medical terminology and insurance processes, along with customer service experience in healthcare. Responsibilities include verifying insurance, confirming benefits, and obtaining authorizations, all while maintaining high service standards.

Qualifications

• High School degree with coursework in Medical Terminology.
• 1-2 years experience in customer service healthcare or patient billing.

Responsibilities

• Verifying patient insurance and confirming benefits eligibility.
• Obtaining authorizations and ensuring accurate patient billing.

Skills

Knowledge of Medical Terminology

Insurance processes

Customer service

Education

High School Degree or equivalent

Tools

Automated patient account systems

Online verification systems

Job description

Join to apply for the Financial Clearance Representative III role at TriHealth.

This position is responsible for verifying patient insurance, confirming benefits eligibility, performing authorization and pre-certification, calculating and estimating patient liability, and notifying third-party coverage providers as required. The goal is to ensure that TriHealth patient insurance information is accurate and up to date to facilitate payment for services rendered. Additionally, this role involves reviewing medical records to obtain information such as diagnoses, prior treatments, signs and symptoms, medications, and other medical details to submit authorization requests for surgeries, testing, or treatments.

Job Overview:

This is a REMOTE POSITION. Must reside in OH, KY, or IN. The responsibilities include verifying patient insurance, confirming benefits, processing authorizations, and discussing complex medical terms with physician office staff.

Job Requirements:

• High School Degree or equivalent with coursework in Medical Terminology
• Knowledge of Medical Terminology and insurance processes
• Understanding of government and non-government third-party benefits and coverage rules
• 1-2 years experience in customer service healthcare, managed care, or patient billing
• Experience with automated patient account systems or online verification systems

Job Responsibilities:

Specific responsibilities are aligned with verifying insurance, obtaining authorizations, and ensuring accurate patient billing processes.

Working Conditions:

Includes frequent concentration, reading, talking, thinking, use of hands, walking, and occasional reaching, standing, and stooping. The role emphasizes service standards and behaviors such as welcoming, recognizing, respecting, valuing, and engaging with patients and team members.

Additional Information:

Level: Entry level, Full-time, in the healthcare industry.

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