Financial Clearance Specialist

C999 UMass Memorial Health Care, Inc.; Worcester (MA); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Signing bonus available

Job summary

UMass Memorial Health Care in Worcester, MA is seeking a Financial Clearance Specialist responsible for assessing and verifying patient information for scheduled medical services, initiating contact with insurance to obtain eligibility, collecting payments, ensuring pre-certification, and guiding patients to financial counselors.

The role requires 4+ years in a business office with hospital revenue cycle experience, HS diploma with associate degree preferred, and familiarity with hospital

Qualifications

• Minimum High School Diploma, or G.E.D., business concentration preferred.
• Associate degree, or higher, preferred.
• Four plus (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.
• 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.

Responsibilities

• Initiates contact with insurance companies to obtain eligibility, gather accurate patient billing information, and performs collections with outstanding accounts receivable.
• Estimates patient financial liability and answers inquiries regarding liability and variables involved.
• Receives and processes patient payments.
• Ensures pre-certification authorization or referral is in place prior to service.
• Refers patients to Financial Counselors or Business Office as needed.
• Reschedules appointments when necessary due to financial circumstances.
• Enters notes regarding financial clearance status in the system.
• Adheres to Financial Clearance Policy in all patient cases.
• Assess gaps in patient coverage to determine financial exposure.
• Be flexible to changing needs and reprioritize work as required.
• Performs other duties to ensure smooth department operation.

Skills

Revenue cycle experience

Healthcare environment

Education

High School Diploma or GED

Associate degree preferred

Job description

Are you a current UMass Memorial Health caregiver?

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)
This position may have a signing bonus 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. Responsible for assessing and verifying patient information for scheduled for medical services.

I. Major Responsibilities

1. Initiates contact with insurance companies to obtain eligibility, gather accurate patient billing information, and performs collections with outstanding accounts receivable.
2. 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 able to explain the variables involved.
3. Receives and processes patient payments.
4. Ensures pre-certification authorization and or referral is in placement prior to service being rendered.
5. Appropriately referring patients to Financial Counselors or Business Office dependent on need of patient.
6. Reschedules appointments when requested by patient or, under advisement of department leader, when due to financial circumstances appointment requires postponement.
7. Enters clear, concise notes concerning financial clearance status in system based on communications.
8. Demonstrate knowledge and understanding of all job-related policies and procedures and adheres to and consistently applies the Financial Clearance Policy in all patient cases.
9. Assesses gaps in patient coverage to determine patient financial exposure prior to rendering service.
10. Consistently demonstrates ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary.
11. Performs other duties as assigned, or directed, to ensure smooth operation of the department/unit.

II. Position Qualifications

License/Certification/Education: Preferred:

1. Minimum High School Diploma, or G.E.D., business concentration preferred.
2. Associate degree, or higher, preferred.

Experience/Skills: Required:

1. Four plus (4+) years of experience within a business office setting, hospital revenue cycle preferred, Physician office or collection agency.
2. Prior experience in a healthcare environment required.

Preferred:

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

Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements. Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents.

III. Physical Demands and Environmental Conditions

• 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: 1. 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. We’re striving to make respect a part of everything we do at UMass Memorial Health – for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.

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.

At UMass Memorial Health, everyone is a caregiver. No matter their responsibilities or title, every employee or "caregiver" fills an important role for our patients and their families every day. Who is a caregiver? It’s not just the person who delivers the care. It’s all the people who make it work … and make it better. Caregivers give everything that helps patients heal, from expertise to extra attention. They give clean, comfortable rooms. Fast, accurate answers. And an easier, less stressful experience. They give warm, reassuring smiles, and helping hands. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, our community and each other. And everyone, in their own unique way, plays an important part, every day.