Financial Clearance Specialist

Catholic Health; Melville (NY); On-site; USD 29,000 - 37,000; Full time

Job summary

Catholic Health is seeking a Financial Clearance Authorization Coordinator in Melville, NY. You will verify insurance eligibility, obtain authorizations, and communicate financial responsibilities to patients, collaborating across Revenue Cycle and clinical teams.

Ideal candidates have 2+ years in Revenue Cycle or Patient Access, strong knowledge of insurance requirements, and excellent interpersonal skills for patient interactions under pressure.

Qualifications

• Must have comprehensive understanding of insurance pre-certification requirements, contract benefits, and medical terminology.
• Experience accessing online insurance eligibility and pre-certification systems.
• Minimum 2 years in Revenue Cycle Management or Patient Access functions; insurance verification and pre-certification experience preferred.
• Customer-focused with strong interpersonal and communication skills.
• Able to discuss and finalize financial arrangements with patients under stressful conditions.

Responsibilities

• Determine whether authorization is required and secure authorization per payer requirements.
• Submit prior authorization requests to payers for hospital or physician.
• Ensure required clinical documents are complete and timely for submissions.
• Coordinate Peer-to-Peer reviews between medical directors and physicians.
• Collaborate with clinical staff to provide proof of medical necessity.
• Utilize WQs and reports to ensure completion of financial clearance tasks for all patients.
• Confirm and document patients' health insurance coverage details and liabilities.
• Obtain and document estimated patient responsibility prior to service and refer to financial counseling when needed.
• Resolve issues related to insurance coverage and prior authorizations; communicate risks to management.
• Propose improvements to enhance operational efficiency; stay informed on regulatory requirements.

Skills

Insurance pre-certification

Medical terminology

Online eligibility systems

Customer service

Problem solving

Policy interpretation

Confidentiality

PC skills

Education

2+ years Revenue Cycle / Patient Access experience

Job description

Catholic Health is seeking a Financial Clearance Authorization Coordinator in Melville, NY. You will verify insurance eligibility, obtain authorizations, and communicate financial responsibilities to patients, collaborating across Revenue Cycle and clinical teams.

Ideal candidates have 2+ years in Revenue Cycle or Patient Access, strong knowledge of insurance requirements, and excellent interpersonal skills for patient interactions under pressure.