Financial Clearance Representative III

TriHealth; Norwood (OH); Remote; USD 36,000 - 54,000; Full time

Benefits offered by this job

Medical, dental, vision

Paid time off

Retirement savings plans

Tuition reimbursement

Job summary

TriHealth seeks a Financial Clearance Representative to verify patient insurance, confirm benefits, and handle pre-certification and patient liability. The role supports revenue cycle and ensures accurate insurance data for timely payments.

Includes work-from-home scheduling with a standard M-F, 8:30 AM–5:00 PM, and a comprehensive benefits package. Prior experience in healthcare billing and third-party verification is preferred.

Qualifications

• High School Diploma or equivalent with Medical Terminology knowledge.
• Knowledge of medical terminology and insurance vocabulary.
• Experience in healthcare patient support or revenue cycle setting.
• Experience with verification/precertification and third‑party benefits preferred.

Responsibilities

• Verify patient insurance and benefits eligibility.
• Perform authorizations and precertifications as required by providers.
• Calculate and communicate patient liability and payment responsibilities.
• Review medical records to obtain info for authorizations (surgery, tests, treatment).

Skills

Customer service

Healthcare terminology

Communication skills

Attention to detail

Education

High School Diploma with Medical Terminology

Tools

Automated patient accounts system

Online verification systems

Job description

Job Description

At TriHealth, our Financial Clearance Representatives play a critical role in ensuring every patient begins their care journey with clarity, compassion, and confidence. You are at the front line of financial advocacy—helping patients understand coverage, removing barriers to care, and contributing directly to a seamless, trusted healthcare experience.

Location

Work from home

Schedule

8:30 AM- 5:00 PM, M-F

Incentives & Benefits

We offer competitive shift differentials, opportunities for professional growth, and a comprehensive benefits package that may include medical, dental, vision, paid time off, retirement savings plans, and tuition reimbursement.

• PRN positions not eligible for TriHealth benefits

https://careers.trihealth.com/what-we-offer/benefits

Minimum Job Requirements

• High School Degree in Medical terminology course or equivalent knowledge
• Knowledge of Medical Terminology
• Insurance vocabulary and processes
• Government and Non-government third party benefits and coverage rules
• Understanding of the impact financial clearance services has on revenue cycle operations and financial performance
• 1-2 years experience Customer Service Healthcare Dedication to treating both internal and external constituents as clients and customers Maintaining a flexible customer service approach and orientation that emphasizes service satisfaction and quality
• Background in managed care or patient billing
• 1-2 years experience Technical Healthcare
• Must have one year experience in insurance verification or precertification experience
• Experience with automated patient account system or online verification systems

Job Overview

This position is responsible for verifying patient insurance, confirming benefits eligibility, performing authorization and pre-certification, calculating and estimating patient liability, and/or notification as required by third party coverage providers. Purpose of this job is to verify that TriHealth patient insurance information is accurate and up to date so payment will be received for services rendered. Additionally, this position requires the knowledge to review medical records obtaining information such as diagnosis, prior treatment, sign and symptoms, medication and other medical information to submit requests for authorizations for surgery, testing or treatment.

Working Conditions

• Climbing - Rarely
• Concentrating - Consistently
• Continuous Learning - Frequently
• Hearing: Conversation - Consistently
• Hearing: Other Sounds - Rarely
• Interpersonal Communication - Consistently
• Kneeling - Rarely
• Lifting <10 Lbs - Rarely
• Lifting 50+ Lbs - Rarely
• Lifting 11-50 Lbs - Rarely
• Pulling - Rarely
• Pushing - Rarely
• Reaching - Occasionally
• Reading - Consistently
• Sitting - Frequently
• Standing - Occasionally
• Stooping - Occasionally
• Talking - Consistently
• Thinking/Reasoning - Consistently
• Use of Hands - Consistently
• Color Vision - Rarely
• Visual Acuity: Far - Consistently
• Visual Acuity: Near - Consistently
• Walking - Frequently

TriHealth SERVE Standards and ALWAYS Behaviors

At TriHealth, We Believe There Is No Responsibility More Important Than To SERVE Our Patients, Our Communities, And Our Fellow Team Members. To Achieve Our Vision And Mission, ALL TriHealth Team Members Are Expected To Demonstrate And Live The Following

Serve: ALWAYS...

• Welcome everyone by making eye contact, greeting with a smile, and saying "hello"
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
• Refrain from using cell phones for personal reasons in public spaces or patient care areas

Excel: ALWAYS...

• Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met
• Offer patients and guests priority when waiting (lines, elevators)
• Work on improving quality, safety, and service

Respect: ALWAYS...

• Respect cultural and spiritual differences and honor individual preferences.
• Respect everyone’s opinion and contribution, regardless of title/role.
• Speak positively about my team members and other departments in front of patients and guests.

Value: ALWAYS...

• Value the time of others by striving to be on time, prepared and actively participating.
• Pick up trash, ensuring the physical environment is clean and safe.
• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.

Engage: ALWAYS...

• Acknowledge wins and frequently thank team members and others for contributions.
• Show courtesy and compassion with customers, team members and the community