Financial Clearance Specialist

UMass Memorial Health; Worcester (MA); On-site; USD 50,000 - 70,000; Full time

Benefits offered by this job

Signing Bonus may be available

Opportunities for professional development

Job summary

UMass Memorial Health is seeking a financial clearance specialist to join their team in Worcester, MA. This role involves working with insurance providers, processing patient payments, and ensuring compliance with financial clearance policies. Candidates should have at least 4 years of relevant experience in a healthcare setting and possess strong communication skills.

The position operates Monday through Friday from 8 AM to 5 PM, emphasizing patient care and financial responsibility. Join a dedicated team committed to providing exceptional care to the community.

Qualifications

• Minimum of 4 years of experience in business office, preferably in a hospital context.
• Experience in a healthcare environment is required.
• Ability to handle third-party collections and reimbursement is preferred.

Responsibilities

• Initiates contact with insurance companies to obtain eligibility and billing information.
• Processes patient payments and ensures proper financial clearance.
• Demonstrates knowledge of financial clearance policies and assists with patient inquiries.

Skills

Experience with insurance companies

Patient billing knowledge

Communication skills

Problem-solving skills

Detail-oriented

Education

High school diploma or G.E.D.

Associate degree or higher

Tools

Business office applications

Hospital computer systems

Job description

Are you a current UMass Memorial Health caregiver? Apply now through Workday.

Exemption Status: Non-Exempt

Schedule Details: Monday through Friday

Scheduled Hours: 8-5

Shift: 1 - Day Shift, 8 Hours (United States of America)

Hours: 40

Cost Center: 99940 - 5478 Financial Clearance

Union: SHARE (State Healthcare and Research Employees)

Signing Bonus: May be available; a member of the Recruitment Team will confirm eligibility during the interview process.

Everyone is a caregiver. At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.

Major Responsibilities

• Initiates contact with insurance companies to obtain eligibility, gather accurate patient billing information, and performs collections with outstanding accounts receivable.
• Accurately estimates the patient financial liability (copayments, deductibles, coinsurances, deposits, etc.) via obtaining accurate demographic and financial information. Answers patient inquiries regarding their liability and explains the variables involved.
• Receives and processes patient payments.
• Ensures pre‑certification authorization and/or referral is in place prior to service being rendered.
• Appropriately refers patients to Financial Counselors or Business Office depending on need.
• Reschedules appointments when requested by patient or, under advisement of department leader, when financial circumstances require postponement.
• Enters clear, concise notes concerning financial clearance status in the system based on communications.
• Demonstrates knowledge and understanding of all job‑related policies and procedures and consistently applies the Financial Clearance Policy in all patient cases.
• Assesses gaps in patient coverage to determine patient financial exposure prior to rendering service.
• Consistently demonstrates ability to respond to changing situations flexibly to meet current needs, such as reprioritizing work as necessary.
• Performs other duties as assigned or directed to ensure smooth operation of the department/unit.

Position Qualifications

License / Certification / Education

Preferred:

• Minimum high school diploma, or G.E.D., business concentration preferred.
• Associate degree, or higher, preferred.

Experience & Skills

Required:

• Four or more (4+) years of experience within a business office setting, hospital revenue cycle preferred, physician office or collection agency.
• Prior experience in a healthcare environment required.

Preferred:

• Working knowledge of personal computers and business office applications preferred.
• Familiarity with hospital computer systems is a plus.
• Knowledge of third‑party collections and reimbursement preferred.

Unless certification, licensure or registration is required, an equivalent combination of education and experience that provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements.

Physical Demands and Environmental Conditions

On‑the‑job time is spent in the following physical activities:

• Stand – 1/3
• Walk – 1/3
• Sit – 2/3
• Talk or hear – 2/3
• Uses hands to finger, handle or feel – 2/3

This job requires that weight be lifted, or force be exerted:

• Up to 10 pounds – 1/3

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

As an equal‑opportunity and affirmative‑action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.

If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at [e-mail]. We will make every effort to respond to your request for disability assistance as soon as possible.