Financial Clearance Specialist (Pre-Authorization exp required) - REMOTE )

Vanderbilt Health; Nashville (TN); Remote; USD 35,000 - 45,000; Full time

Job summary

A prominent healthcare institution in Nashville is seeking a Financial Clearance Assistant to assist with patient care financial processes. The role involves verifying insurance information, facilitating patient financial assistance, and ensuring compliance with insurance regulations. The ideal candidate should have at least 2 years of relevant experience and a high school diploma or GED. This position supports a collaborative healthcare environment focused on exceptional patient care.

Qualifications

• Requires 2 years of relevant work experience.
• Must have strong communication skills.
• Capable of following detailed instructions.

Responsibilities

• Assists in financial clearance relating to patient care.
• Obtains certification from insurance companies.
• Verifies insurance information.
• Evaluates patient assets and liabilities.
• Guides patient in applying for financial assistance.

Skills

Problem Solving

Data Entry

Customer Service

Insurance Regulatory Knowledge

Education

High School Diploma or GED

Job description

Overview

Discover Vanderbilt University Medical Center: Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research.

Organization: Financial Clearance

Job Summary

Assists in financial clearance relating to patient care with occasional guidance. Screens patients for referral to other funding resources.

Key Responsibilities

• Obtains certification from insurance companies for all office visits.
• Verifies insurance information and registers cases in tracking system.
• Evaluates patient assets and liabilities to determine ability to pay.
• Reviews alternatives to admission and guides patient in applying for financial assistance.
• Completes pre-certification, credit applications, and other necessary paperwork.
• Performs investigative and follow-up work relating to reimbursement issues.
• The responsibilities listed are a general overview of the position and additional duties may be assigned.
• Performs tasks to support and obtains pre-certifications from insurance companies.

Technical Capabilities

• Problem Solving (Novice): Uses critical thinking and process improvement; describes current state, identifies root causes, creates future state, and develops solutions with a sustainability plan.
• Data Entry (Novice): Transcribes information from the original source into an electronic system according to written and verbal instructions.
• Customer Service (Novice): Focus on customer needs, responsiveness, and courteous service.
• Insurance Regulatory Knowledge (Intermediate): Knowledge of rules and regulations for insurance policies, claims, payment and coverage; ability to interpret and explain rules that are ambiguous.

Our professional administrative functions include critical supporting roles in information technology and informatics, finance, administration, legal and community affairs, human resources, communications and marketing, development, facilities, and many more.

At our growing health system, we support each other and encourage excellence among all who are part of our workforce. High-achieving employees stay at Vanderbilt Health for professional growth, appreciation of benefits, and a sense of community and purpose.

Core Accountabilities

• Organizational Impact: Performs tasks that are typically routine that may impact team's performance with occasional guidance.
• Problem Solving/Complexity: Utilizes some discretion and research to solve routine problems.
• Breadth of Knowledge: Applies knowledge of standards, established processes and procedures that apply to your own job.
• Team Interaction: Provides guidance to entry level co-workers.

Core Capabilities

• Supporting Colleagues: Develops Self and Others; Builds and Maintains Relationships; Communicates Effectively.
• Delivering Excellent Services: Serves Others with Compassion; Solves Complex Problems; Offers Meaningful Advice and Support.
• Ensuring High Quality: Performs Excellent Work; Fulfills Safety and Regulatory Requirements.
• Managing Resources Effectively: Demonstrates Accountability; Stewards Organizational Resources; Makes Data Driven Decisions.
• Fostering Innovation: Generates New Ideas; Applies Technology; Adapts to Change.

Position Qualifications

Responsibilities:

Certifications:

Work Experience:

Relevant Work Experience

Experience Level:

2 years

Education:

High School Diploma or GED

Vanderbilt Health is committed to fostering an environment where everyone has the chance to thrive and is committed to the principles of equal opportunity. EOE/Vets/Disabled.