Financial Clearance Specialist Associate (work from home Pennsylvania resident)

Geisinger; Danville (PA); Remote; USD 35,000 - 45,000; Full time

Job summary

A leading healthcare provider in Pennsylvania is seeking a dedicated professional to manage pre-registration for appointments and admissions. The role involves verifying insurance, discussing expenses with patients, and ensuring compliance with organizational policies. Join a collaborative team committed to excellence and patient care.

Benefits

Comprehensive healthcare benefits from day one

Qualifications

• Minimum 1 year relevant experience required.

Responsibilities

• Perform pre-registration while maintaining HIPAA guidelines.
• Verify insurance for various payers and document information.
• Discuss payment options with patients and collect payments.

Education

High School Diploma or GED

Job description

Job Summary: Provides seamless pre-registration for scheduled ambulatory appointments and hospital scheduled admissions. Completes insurance verification, documents out-of-pocket expenses, and acquires necessary referrals. Reviews insurance benefits with patients and attempts to collect copays, deductibles, coinsurance, outstanding balances, and pre-service payments to contribute to department point-of-service collections.

Job Duties:

1. Perform complete and accurate pre-registration while maintaining HIPAA guidelines when contacting patients via phone to verify demographics and insurance information.
2. Discuss out-of-pocket expenses, outstanding balances, or pre-service payments with patients, attempting to collect on these services.
3. If patients request payment options, transfer calls to department Financial Counselors.
4. Verify insurance for various payers using Passport and manual processes to ensure accurate insurance information in the electronic medical record.
5. For insurances that cannot be processed automatically, contact insurance carriers by phone to obtain eligibility and out-of-pocket expenses.
6. Select the appropriate insurance and visit indicator to ensure correct billing for appointments.
7. For hospital scheduled admissions, prioritize and list the correct coverage on the HAR to ensure proper billing.
8. Review and request referrals as needed for future appointments by sending encounters to Geisinger PCPs and contacting outside PCPs by fax.
9. Complete Medicare Secondary Payer Questionnaire for eligible patients.
10. Enter Financial Comments and Clearance indicators in the software system, documenting demographics, insurance verification, referrals, and signed forms.
11. Use department-established codes for documentation.
12. For hospital admissions, document in the authorization and certification tab.
13. Notify supervisor of unusual circumstances or issues for resolution.
14. Explain and review forms requiring patient signatures, such as AOB, UA, PACK, and NOFR.
15. Meet productivity, quality, and Point of Service collection goals.
16. Organize and prioritize work queues as a team member, assisting coworkers to meet department timeframes.
17. Suggest procedural improvements or innovations to enhance patient experience.

Work is typically performed in an office environment. The role involves satisfying job obligations and complying with organizational policies. The statements are not exhaustive but represent key elements for successful job performance.

Position Details:

• Education: High School Diploma or GED (Required)
• Experience: Minimum 1 year relevant experience (Required)

Our Purpose & Values: We care for patients, members, students, and communities. We value kindness, excellence, learning, innovation, and safety. We offer comprehensive healthcare benefits from day one and foster a collaborative, diverse, and inclusive work environment. We are an affirmative action, equal opportunity employer, encouraging women and minorities to apply. All qualified applicants will receive consideration regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.