Financial Clearance Representative III - Infusion

TriHealth; Cincinnati (OH); Remote; USD 40,000 - 55,000; Full time

Job summary

TriHealth seeks a Financial Clearance Representative III - Infusion to manage insurance coverage verification and authorizations for chemotherapy and oncology treatment plans. The role requires strong knowledge of medical terminology and experience in insurance verification processes, making it ideal for an entry-level candidate in the healthcare industry. This work-from-home position is suitable for local candidates in Cincinnati.

Qualifications

• 1-2 years experience in treatment/therapy plans and pharmaceutical formularies.
• Experience with insurance verification and pre-certification.

Responsibilities

• Verify patient insurance and confirm benefits.
• Obtain authorizations and pre-certifications.
• Review medical records for authorization requests.

Skills

Medical terminology knowledge

Insurance vocabulary

Customer service

Education

High school diploma or equivalent

Job description

Financial Clearance Representative III - Infusion

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

Job Description: This position verifies eligibility and plan coverage for chemotherapy and oncology treatment plans, including pharmaceutical and biosimilar drug formularies. Responsibilities include verifying patient insurance, confirming benefits, obtaining authorizations and pre-certifications, estimating patient liabilities, and ensuring accurate insurance information for payment processing. The role requires knowledge of pharmaceutical prior authorizations, infusion services, and reviewing medical records for authorization requests.

Job Overview: The role involves verifying insurance coverage, performing authorizations, and reviewing medical documents. This work-from-home position requires a Cincinnati-based team member.

Job Requirements:

• High school diploma or equivalent with medical terminology knowledge
• Understanding of medical terminology, insurance vocabulary, and coverage rules
• 1-2 years experience in treatment/therapy plans, pharmaceutical formularies, and customer service in healthcare
• Experience with insurance verification, pre-certification, and online verification systems

Job Responsibilities: Include verifying insurance, obtaining authorizations, and reviewing medical records.

Working Conditions: Include frequent concentration, reading, talking, thinking, use of hands, walking, and occasional reaching, standing, and stooping.

At TriHealth, we value service, excel in our work, respect everyone, value time and resources, and engage courteously with patients and colleagues.

Additional details: Entry level, full-time, in hospitals and healthcare industries.