Medical Authorization & Financial Clearance Specialist

Beth Israel Lahey Health; Lahey (TX); Vor Ort; USD 28.000 - 38.000; Vollzeit

Zusammenfassung

Beth Israel Lahey Health seeks a Financial Clearance Specialist to complete all insurance eligibility and authorization activities for outpatient services. You will verify coverage, check medical necessity, and inform departments of determination results to ensure patient access to care.

You will collaborate with revenue cycle, clinical teams and financial counselors to resolve complex issues, maintain accurate documentation, and comply with coding and payer requirements while upholding patient

Qualifikationen

• High School diploma or GED required; Associate degree preferred.
• 1-3 years related work experience required.
• Knowledge of CPT, HCPCS coding and ICD-9/ICD-10 coding.
• Advanced skills with Microsoft Office and other web-based applications.

Aufgaben

• Verifies patient's insurance eligibility for visit using online tools or payer contact.
• Identifies payer medical necessity before services and informs departments.
• Determines authorization requirements and obtains payer authorizations when needed.
• Escalates issues and coordinates with revenue cycle, leadership and clinical stakeholders.
• Completes work queues and reports; assists with urgent authorization; refers to financial counselors.

Kenntnisse

Microsoft Office

Payer policies knowledge

Financial clearance

Ausbildung

High School diploma or GED

Associate's degree preferred

Tools

Craneware

Jobbeschreibung

Beth Israel Lahey Health seeks a Financial Clearance Specialist to complete all insurance eligibility and authorization activities for outpatient services. You will verify coverage, check medical necessity, and inform departments of determination results to ensure patient access to care.

You will collaborate with revenue cycle, clinical teams and financial counselors to resolve complex issues, maintain accurate documentation, and comply with coding and payer requirements while upholding patient