Financial Clearance Specialist Associate (work from home Pennsylvania resident)

Geisinger; Pennsylvania; Remote; USD 35,000 - 50,000; Full time

Job summary

A leading healthcare organization is seeking a dedicated professional to manage patient pre-registration and insurance verification processes. Responsibilities include ensuring compliance with HIPAA guidelines, discussing financial responsibilities with patients, and maintaining accurate records. The role requires strong organizational skills and the ability to meet productivity goals while enhancing the patient experience.

Responsibilities

• Complete accurate pre-registration while maintaining HIPAA guidelines.
• Verify insurance for various payers using Passport and manual processes.
• Meet productivity, quality, and Point of Service (POS) collection goals.

Job description

Job Responsibilities

1. Complete 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. Transfer calls to department Financial Counselors if patients request payment options.
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 electronically, contact insurance carriers by phone to obtain eligibility and out-of-pocket expenses.
6. Review and select the appropriate insurance and visit indicator to ensure correct billing for cadence 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 telephone encounters to Geisinger Primary Care Providers (PCPs) and contacting outside PCP offices by fax.
9. Complete Medicare Secondary Payer Questionnaire for eligible patients.
10. Enter financial comments and clearance indicators in the appointment info tab within the software system, using established abbreviations.
11. Document demographics, insurance verification, referrals, and patient-signed forms, including those for hospital admissions, in the appropriate system tabs.
12. Notify supervisor of unusual circumstances or issues for resolution.
13. Review and explain necessary forms to patients upon arrival, such as Assignment of Benefits (AOB), Universal Authorization (UA), Privacy Acknowledgment (PACK), and Notice of Financial Responsibility (NOFR).
14. Meet productivity, quality, and Point of Service (POS) collection goals.
15. Organize and prioritize individual work queues as part of the team.
16. Assist coworkers to ensure all work queues are completed within department timeframes.
17. Suggest procedural improvements or innovations to enhance patient experience.

Additional Information

Work is typically performed in an office environment. The employee is accountable for fulfilling all job-specific obligations and complying with organizational policies and procedures. The statements in this profile are not exhaustive but represent the essential elements necessary for successful job performance.