Financial Clearance Specialist, PRN

University of Maryland Medical System Corporation; Bel Air (MD); On-site; USD 45,000 - 65,000; Full time

Job summary

University of Maryland Medical System Corporation is seeking a Financial Clearance Specialist to ensure patients are financially cleared for scheduled and unscheduled healthcare services. You will verify insurance benefits, obtain authorizations, estimate patient financial responsibility, collect applicable payments, and facilitate financial counseling referrals.

The role supports the revenue cycle by liaising with patients, providers, payers, and internal departments to enable timely access to

Qualifications

• High School Diploma or GED required.
• Minimum of two (2) years of experience in healthcare revenue cycle, patient access, registration, scheduling, medical office, hospital operations, or a related healthcare environment required.
• Experience in healthcare registration, scheduling, insurance referral and authorization processes preferred.

Responsibilities

• Perform insurance eligibility and benefits verification for scheduled and unscheduled services.
• Obtain and document routine and complex pre-certifications, prior authorizations, and referrals required by insurance carriers.
• Review medical necessity requirements and ensure compliance with payer guidelines.
• Monitor and follow up on pending authorization requests to ensure timely approval.
• Coordinate with physician offices and clinical staff to gather documentation necessary for authorization requests.
• Research and resolve authorization, referral, and insurance-related issues that may delay patient services.

Skills

Medical terminology

Insurance terminology

Reimbursement practices

Ability to prioritize tasks

Education

High School Diploma or GED

Job description

Job Requirements At UMMS, we are committed to working together to build and sustain a culture of excellence by delivering compassionate, high-quality care and exceptional service to our patients, families, and communities.

Position Summary

The Financial Clearance Specialist is responsible for ensuring patients are financially cleared for scheduled and non-scheduled healthcare services by completing insurance verification, authorization, pre-certification, registration, and financial counseling activities. Under general supervision, this role supports the revenue cycle by validating insurance benefits, obtaining required authorizations, estimating patient financial responsibility, collecting applicable payments, and facilitating financial assistance referrals. The Financial Clearance Specialist serves as a liaison between patients, providers, payers, and internal departments to ensure timely access to care while minimizing authorization-related delays and denials.

Key Responsibilities

• Perform insurance eligibility and benefits verification for scheduled and unscheduled services.
• Obtain and document routine and complex pre-certifications, prior authorizations, and referrals required by insurance carriers.
• Review medical necessity requirements and ensure compliance with payer guidelines.
• Monitor and follow up on pending authorization requests to ensure timely approval.
• Coordinate with physician offices and clinical staff to gather documentation necessary for authorization requests.
• Research and resolve authorization, referral, and insurance-related issues that may delay patient services.

Work Experience Education & Experience

High School Diploma or GED required.

Minimum of two (2) years of experience in healthcare revenue cycle, patient access, registration, scheduling, medical office, hospital operations, or a related healthcare environment required.

Experience in healthcare registration, scheduling, insurance referral and authorization processes preferred.

Knowledge, Skills, and Abilities

• Knowledge of medical terminology, insurance terminology, and healthcare reimbursement practices.
• Understanding of commercial, government, and managed care insurance plans.
• Knowledge of authorization, referral, and eligibility verification processes.
• Ability to prioritize multiple tasks and work in a fast-paced environment.
• Basic knowledge of UB-04 billing forms, Explanation of Benefits (EOBs), CPT, ICD-10 coding, and healthcare billing practices.