Financial Clearance Specialist Associate (work from home Pennsylvania resident)

340B Health; Pennsylvania; Remote; USD 35,000 - 50,000; Full time

Job summary

A healthcare organization seeks a Pre-registration Specialist to facilitate smooth pre-registration for ambulatory appointments and hospital admissions. Key responsibilities include insurance verification, discussing patient financial obligations, and ensuring compliance with HIPAA. The role requires a high school diploma or GED and at least one year of relevant experience.

Benefits

Comprehensive healthcare benefits from day one

Collaborative and inclusive work environment

Qualifications

• Minimum 1 year relevant experience required.
• Experience in patient interactions and insurance processes preferred.

Responsibilities

• Ensure accurate pre-registration while adhering to HIPAA guidelines.
• Verify insurance and discuss out-of-pocket expenses with patients.
• Meet productivity, quality, and point-of-service collection goals.

Skills

Insurance Verification

HIPAA Compliance

Patient Communication

Documentation

Financial Counseling

Education

High School Diploma or GED

Job description

Job Summary: Provides seamless pre-registration for scheduled ambulatory appointments and hospital 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, and outstanding balances to contribute to department point-of-service collections.

Job Duties:

• Ensure complete and accurate pre-registration while maintaining HIPAA guidelines when contacting patients via phone to verify demographics and insurance information.
• Discuss out-of-pocket expenses and outstanding balances with patients, attempting to collect these amounts.
• Transfer calls to department Financial Counselors if patients request payment options.
• Verify insurance for various payers using Passport and manual processes to ensure accurate electronic medical records.
• Contact insurance carriers by phone for eligibility and out-of-pocket expenses when automated processing is unavailable.
• Select appropriate insurance and visit indicators to ensure correct billing for appointments.
• Prioritize and document coverage details for hospital scheduled admissions on the HAR for accurate billing.
• Request referrals for future appointments by sending encounters to PCPs and faxing outside PCP offices.
• Complete Medicare Secondary Payer Questionnaire for eligible patients.
• Enter financial comments and clearance indicators in the software system, documenting demographics, insurance verification, referrals, and signed forms.
• Use department-established codes for documentation.
• For hospital admissions, complete documentation in the authorization and certification tab.
• Notify supervisors of unusual circumstances or issues for resolution.
• Explain and review forms requiring patient signatures, such as AOB, UA, PACK, and NOFR.
• Meet productivity, quality, and POS collection goals.
• Organize and prioritize work queues as a team member and assist coworkers to meet department timeframes.
• Suggest procedural improvements to enhance patient experience.

Work is typically performed in an office environment. Responsible for fulfilling all job obligations and organizational policies. This profile outlines typical elements necessary for successful job performance.

Position Details:

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

Our purpose and values emphasize caring, 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 equal opportunity employer committed to diversity and inclusion.