Financial Clearance Specialist

Shepherd Center; Atlanta (GA); On-site; USD 55,000 - 75,000; Full time

Job summary

Shepherd Center seeks a Financial Clearance Specialist to verify insurance coverage, interpret benefits, coordinate authorizations, and provide patient financial counseling. The role supports reductions in financial risk and ensures regulatory compliance while collaborating with Patient Access and Patient Financial Services.

Responsibilities include explaining benefits to patients, documenting discussions, negotiating payment plans, and guiding patients through the Financial Assistance Program.

Qualifications

• Requires 3-5 years of progressive experience in patient access, financial clearance, healthcare billing, or related revenue cycle functions.
• High School Diploma or GED is required.
• Strong knowledge of insurance benefits, authorizations, and payer determinations.

Responsibilities

• Explain insurance benefits, coverage limits, estimates, and financial responsibility to patients and families.
• Explain EOBs, authorizations, denials, and payer determinations to patients and families.
• Document benefit details, estimates, and discussions in the system with CMS and price transparency compliance.
• Establish and negotiate payment plans following organizational policy.
• Explain Shepherd Center's Financial Assistance Program and coordinate required documentation.
• Perform POS collections, manage cash, and handle credit card transactions with accuracy.

Skills

Commercial insurance knowledge

Managed care understanding

Government insurance knowledge

Benefits interpretation

Payer determinations interpretation

Empathetic financial conversations

Education

High School Diploma or GED

Tools

Epic

Microsoft Office

Job description

About Shepherd Center

With five decades of experience, Shepherd Center provides world-class clinical care, research, and family support for people experiencing the most complex conditions, including spinal cord and brain injuries, multi-trauma, traumatic amputations, stroke, multiple sclerosis, and pain. An elite center ranked by" U.S. News "as one of the nation's top hospitals for rehabilitation, Shepherd Center is also recognized as both Spinal Cord Injury and Traumatic Brain Injury Model Systems. Shepherd is the only rehabilitation facility in the nation with an intensive care unit on-site, allowing us to care for the most complex patients and begin the rehabilitation process sooner. Shepherd Center treats thousands of patients annually with unmatched expertise and unwavering compassion to help them begin again. Shepherd Center's culture is one of hope, humor, and hard work. You will enjoy career growth, strong relationships with co-workers , strong support from leadership, and fun activities that have ke pt over 1 2% of staff members working at Shepherd for more than 20 years .

The Financial Clearance Specialist is responsible for ensuring patients are financially cleared prior to services by verifying insurance coverage, interpreting benefits, coordinating authorizations, delivering estimates, and providing financial counseling. This role serves as a key liaison between Patient Access Services, Patient Financial Services, and patients to reduce financial risk, ensure regulatory compliance, and enhance the patient's financial experience.

JOB RESPONSIBILITIES

Provide expert guidance to patients and families by explaining insurance benefits, coverage limitations, estimates, and financial responsibility for planned or received servicesInterpret and explain benefits, explanations of benefits (EOBs), authorizations, denials, and payer determinations to patients and familiesDocument benefit details, estimates, and financial discussions accurately within the EHREnsure compliance with CMS-required notices, the No Surprises Act, and price transparency requirements, including delivery and explanation of patient estimatesEstablish and negotiate payment plans with patients as appropriate and in accordance with organizational policyServe as the first point of contact for explaining Shepherd Center's Financial Assistance Program (FAP) and coordinate submission of required documentationPerform POS collections, maintain cash drawer accuracy, process credit card transactions, and communicate effectively with patients and guarantors regarding balancesCollaborate closely with Insurance Verification Specialists, escalating complex coverage, authorization, or financial clearance issues as neededReceives escalations from Insurance Verification Specialists for complex financial clearance scenariosPartner with Patient Financial Services, Case Management, Managed Care, and insurance carriers to resolve complex financial and coverage scenariosMeet with patients and families in clinics or at the bedside as required, demonstrating compassion, professionalism, and financial expertiseAnswer incoming calls, respond to voicemails and emails, and route patient inquiries appropriately in a timely mannerMaintain working knowledge of registration workflows and provide cross-coverage support for outpatient clinics as neededPractices proper safety techniques in accordance with Center and departmental policies and procedures. Responsible for the reporting of employee/patient/visitor injuries or accidents, or other safety issues to the supervisor and in the occurrence notification system. Monitors and ensures compliance with all regulatory requirements, organizational standards, and policies and procedures related to area of responsibility. Identifies potential risk areas within area of responsibility and supports problem resolution process.

REQUIRED MINIMUM EDUCATION

High School Diploma or GED required

REQUIRED MINIMUM CERTIFICATION

N/A

REQUIRED LICENSURE

N/A

REQUIRED MINIMUM EXPERIENCE

3-5 years of progressive experience in patient access, financial clearance, healthcare billing, or related revenue cycle functions, preferably in a hospital or physician enterprise.

REQUIRED MINIMUM SKILLS

Strong working knowledge of commercial, managed care, and governmental insurance plansDemonstrated ability to interpret benefits, authorizations, and payer determinations independentlyStrong math aptitude and financial acumenExcellent written and verbal communication skillsProficiency with Epic and Microsoft Office toolsAbility to manage sensitive financial conversations with professionalism and empathy

PREFERRED QUALIFICATIONS

Associates or Bachelor's degree preferredCPAR or CHAA preferredCHAM or HFMA CRCR a plus

PHYSICAL DEMANDS

Sedentary work with occasional standing, walking, or lifting up to 15 pounds.

WORKING CONDITIONS

No potential for exposure to blood and body fluids.