Hospital Patient Financial Clearance Expert

Trinity Health; Ann Arbor (MI); Sur place; USD 45 000 - 65 000; Plein temps

Résumé du poste

Trinity Health in Michigan seeks a Financial Clearance Specialist II to manage pre-service financial clearance and collection prior to the date of service. You will obtain and verify insurance information, validate benefits, obtain authorizations, and initiate the billing process for hospital services.

Responsibilities include complex, high-dollar services across surgical, observation, and in-house cases, with verification across outpatient, elective, and urgent settings.

Qualifications

• High School Diploma or equivalent is required.
• Two to Five years experience in area of expertise such as scheduling, financial clearance, or patient access.
• National certification in HFMA CRCR required within one year of hire.
• Proficiency in Patient Registration/Patient Accounting systems and related software systems.

Responsabilités

• Performs insurance eligibility/benefit verification using a variety of mechanisms (EDI, payer web access, or payer calls) and documents information in the EMR system.
• Informs patient/guarantor of liabilities and collects co-pays, deductibles, and balances at pre-registration; provides financial education and refers to financial counseling when needed.
• Documents payments/actions in the patient accounting system and provides the patient with a payment receipt.
• Validates medical necessity (LMRP/LCD review) for Medicare and Non-Medicare cases to ensure clearance.
• Coordinates with scheduling and/or ancillary staff for clarification of diagnosis/test(s) when needed.

Formation

High School Diploma or equivalent

Associate's degree preferred

Outils

Patient Registration/Patient Accounting systems

Description du poste

Trinity Health in Michigan seeks a Financial Clearance Specialist II to manage pre-service financial clearance and collection prior to the date of service. You will obtain and verify insurance information, validate benefits, obtain authorizations, and initiate the billing process for hospital services.

Responsibilities include complex, high-dollar services across surgical, observation, and in-house cases, with verification across outpatient, elective, and urgent settings.