Financial Clearance Specialist Remote Position

UMass Memorial Health; Worcester (MA); Remote; USD 59,935,000 - 83,871,000; Full time

Benefits offered by this job

Signing bonus potential

Job summary

UMass Memorial Health is seeking a Financial Clearance Specialist to assess and verify patient information for scheduled medical services and to collect co-pays, deductibles, and coinsurances. You will estimate liabilities, handle payments, and ensure pre-certifications are in place prior to service.

The role requires experience in a hospital revenue cycle, strong attention to detail, and solid customer service skills. Signing bonus may be available; join a team dedicated to respectful care.

Qualifications

• Minimum high school diploma or GED; associate degree preferred.
• 4+ years in a business office or hospital revenue cycle setting.
• Healthcare environment experience is preferred.

Responsibilities

• Initiates contact with insurance to obtain eligibility and perform collections.
• Estimates patient financial liability using demographic and financial data.
• Receives and processes patient payments.
• Ensures pre-certification or referral is in place before services.
• Directs patients to Financial Counselors or Business Office as needed.
• Reschedules appointments when financial circumstances require.
• Notes financial clearance status clearly in the system.
• Adheres to Financial Clearance Policy in all cases.
• Assesses insurance gaps to determine patient financial exposure.
• Responds flexibly to changing priorities and workflows.
• Performs other duties as assigned.

Skills

Financial clearance

Patient billing

Collections

Customer service

Attention to detail

Education

High School Diploma or GED

Associate degree, preferred

Tools

Billing software

EMR/EHR systems

Job description

Are you a current UMass Memorial Health caregiver? Apply now through Workday.Exemption Status:Non-ExemptHiring Range:$20.94 - $29.27(based on a full time schedule of 40 hours per week).Please note that the final offer will vary based on scheduled hours. Compensation for part-time or reduced schedules will be prorated based on scheduled weekly hours, experience, skills, qualifications, and internal equity considerations.Schedule Details:Monday through FridayScheduled Hours:8am-4:30pmShift:1 - Day Shift, 8 Hours (United States of America)Hours:32Cost Center:99940 - 5478 Financial ClearanceUnion:SHARE (State Healthcare and Research Employees)This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.Everyone Is a CaregiverAt UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.Responsible for assessing and verifying patient information for scheduled for medical services. This requires verification of patient’s demographic, financial and insurance information. Collects co-pays, deductibles, coinsurances, and down payments. Provides estimates for services when appropriate. Receives and processes patient financial liability payments for current and past balances. The focus is to collect patient liabilities prior to service and to resolve any insurance and financial issues prior to services being rendered. Reschedules appointments when appropriate under the guidance of department leader. This position is the front line for customer service, pre-registration and access to care for scheduled services.I. Major Responsibilities:1. Initiates contact with insurance companies to obtain eligibility, gather accurate patient billing information, and performs collections with outstanding accounts receivable.2. Accurately estimates the patient financial liability (copayments, deductibles, coinsurances, deposits, etc. via obtaining accurate demographic and financial information). Answers patient inquiries regarding their liability and able to explain the variables involved.3. Receives and processes patient payments.4. Ensures pre-certification authorization and or referral is in placement prior to service being rendered.5. Appropriately referring patients to Financial Counselors or Business Office dependent on need of patient.6. Reschedules appointments when requested by patient or, under advisement of department leader, when due to financial circumstances appointment requires postponement.7. Enters clear, concise notes concerning financial clearance status in system based on communications.8. Demonstrate knowledge and understanding of all job-related policies and procedures and adheres to and consistently applies the Financial Clearance Policy in all patient cases.9. Assesses gaps in patient coverage to determine patient financial exposure prior to rendering service.10. Consistently demonstrates ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary.11. Performs other duties as assigned, or directed, to ensure smooth operation of the department/unit.II. Position Qualifications:License/Certification/Education:Required:1. Minimum High School Diploma, or G.E.D., business concentration preferred.Preferred:1. Associate degree, or higher, preferred.Experience/Skills:Required:1. Four plus (4+) years of experience within a business office setting, hospital revenue cycle preferred, Physician office or collection agency.2. Prior experience in a healthcare environment required.Preferred:1. Working knowledge of personal computers and business office applications preferred.2. Familiarity with hospital computer systems is a plus.3. Knowledge of third party collections and reimbursement preferred.Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements.Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents.III. Physical Demands and Environmental Conditions:On-the-job time is spent in the following physical activities:1. Stand - 1/32. Walk - 1/33. Sit - 2/34. Talk or hear - 2/35. Uses hands to finger, handle or feel - 2/3This job requires that weight be lifted, or force be exerted:1. Up to 10 pounds - 1/3All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.We’re striving to make respect a part of everything we do at UMass Memorial Health – for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at [e-mail]. We will make every effort to respond to your request for disability assistance as soon as possible.