Patient Financial Clearance Representative - One Capital Square - Days Remote

Davita Inc.; Richmond (VA); Remote; USD 36,000 - 50,000; Full time

Job summary

A leading healthcare company seeks a Patient Fin Clearance Rep to oversee financial clearance processes for patients. This role involves verifying insurance information, calculating patient liabilities, and ensuring clarity in financial communications. Successful candidates will have strong problem-solving abilities and experience in healthcare insurance operations.

Qualifications

• 3+ years in a healthcare setting, including insurance plans.
• Experience in medical billing and authorization.
• Post-high school coursework in healthcare is preferred.

Responsibilities

• Manage financial clearance activities for patients.
• Verify insurance eligibility and calculate patient liabilities.
• Communicate patient financial responsibilities clearly.

Skills

Communication

Problem-solving

Attention to detail

Education

High School Diploma or equivalent

Tools

Microsoft Office

GE-IDX Patient Registration

Job description

The Patient Fin Clearance Rep is responsible for managing the entire scope of financial clearance activities for assigned patients before their scheduled appointments. Financial clearance includes, but is not limited to, confirming completeness of patient registration data, verifying insurance eligibility, confirming health plan benefits, procuring PCP referrals and health plan authorizations, calculating and collecting patient liability estimates, restricting or redirecting out-of-network patients, and communicating patient financial responsibilities.

The Patient Fin Clearance Rep ensures that patient financial responsibilities are communicated with consistency, clarity, and transparency, so patients understand the costs of services, their insurance coverage and limitations, and their individual responsibilities. Successful performance of these duties directly impacts the health system's goals of streamlining clinical workflows and improving revenue cycle operations and financial performance.

Qualifications

• Experience REQUIRED: Minimum three (3) years in a healthcare setting, including experience with commercial, managed care, and governmental health insurance plans; at least one (1) year in insurance plan authorization and referral requirements or medical billing; proficiency with computers and software applications such as Microsoft Office.
• Experience PREFERRED: Experience with GE-IDX Patient Registration or similar systems, ICD and CPT coding, and medical terminology.
• Education/Training REQUIRED: High School Diploma or equivalent.
• Education/Training PREFERRED: Post-high school coursework in healthcare or medical billing.

Key Responsibilities

• Collect and update patient demographic and insurance information.
• Verify insurance eligibility and benefits using various tools and contact payers or patients as needed.
• Calculate patient out-of-pocket liability and collect deposits, co-pays, deductibles, and balances prior to services.
• Refer patients to financial counselors for assistance with payment plans or alternate payers.
• Secure PCP referrals and prior authorizations from health plans, coordinating peer-to-peer reviews when necessary.
• Prepare forms for third-party payments and determine when to update patient accounts.
• Maintain knowledge of healthcare plans and authorization requirements.

Additional Requirements

• May require extended work hours, including evenings.
• Physical activities include lifting 20-50 lbs, prolonged sitting, reaching, repetitive motions, and extensive keyboard use.
• Must demonstrate strong recall, reasoning, problem-solving, communication, and focus skills.
• Work environment may be fast-paced, noisy, and involve handling multiple priorities and customer interactions.

This job posting is active and accepting applications.