Financial Clearance Specialist

Shepherd Center; Atlanta (GA); On-site; USD 40,000 - 60,000; Full time

Job summary

The Shepherd Center is seeking a Financial Clearance Specialist to ensure patients are financially cleared before services. You will verify insurance coverage, interpret benefits, deliver estimates, and coordinate authorizations, acting as the liaison between Patient Access Services and Patient Financial Services.

You will explain benefits, EOBs, and payment obligations to patients and families, negotiate payment plans, and ensure compliance with CMS, No Surprises Act, and price transparency

Qualifications

• High School Diploma or GED required.
• Experience in patient access, financial clearance, healthcare billing, or related revenue cycle functions preferred.
• Strong math aptitude and financial acumen.
• Excellent written and verbal communication.
• Proficiency with Epic and Microsoft Office tools.

Responsibilities

• Provide expert guidance to patients and families by explaining insurance benefits and financial responsibility.
• Interpret and explain benefits, EOBs, authorizations, denials, and payer determinations.
• Document benefit details and discussions accurately within the EHRE.
• Ensure CMS-required notices, No Surprises Act, and price transparency compliance.
• Establish and negotiate payment plans with patients as appropriate.
• Coordinate submission of documentation for Shepherd Center's Financial Assistance Program.
• Perform POS collections and maintain cash drawer accuracy.
• Collaborate with Insurance Verification Specialists and other teams to resolve issues.

Skills

Insurance benefits interpretation

Financial counseling

Communication with patients

Regulatory compliance

Education

High School Diploma or GED

Job description

About Shepherd CenterWith 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 kept over 12% 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 RESPONSIBILITIESProvide 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 EDUCATIONHigh School Diploma or GED requiredREQUIRED MINIMUM CERTIFICATIONN/AREQUIRED LICENSUREN/AREQUIRED MINIMUM EXPERIENCE3–5 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 SKILLSStrong 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 empathyPREFERRED QUALIFICATIONSAssociates or Bachelor's degree preferredCPAR or CHAA preferredCHAM or HFMA CRCR a plusPHYSICAL DEMANDSSedentary work with occasional standing, walking, or lifting up to 15 pounds.WORKING CONDITIONSNo potential for exposure to blood and body fluids.