Patient Financial Clearance Representative - One Capital Square - Remote

Virginia Commonwealth University Health; Richmond (VA); Remote; USD 42,000 - 54,000; Full time

Job summary

The Patient Financial Clearance Representative at One Capital Square in Richmond, VA is responsible for ensuring patients have complete registration data, verify insurance eligibility, determine patient liability, and obtain necessary referrals and authorizations before services.

You will communicate financial responsibilities clearly to patients, coordinate with financial counselors, and help streamline revenue cycle processes in a busy health system.

Qualifications

• Minimum three years in a health care setting.
• Experience with commercial, managed care and governmental plans.
• Experience in insurance plan authorization and referrals.

Responsibilities

• Verify insurance eligibility and benefits for patients.
• Calculate out-of-pocket liability and collect deposits, co-pays, and balances.
• Obtain referrals and prior authorizations as required by health plans.

Skills

Customer service

Communication

Problem solving

Attention to detail

Medical terminology

Education

High School Diploma or equivalent

Tools

Microsoft Office

Email

Job description

Patient Financial Clearance Representative - One Capital Square - Remote page is loaded## Patient Financial Clearance Representative - One Capital Square - Remotelocations: Richmond, VAtime type: Full timeposted on: Posted Todayjob requisition id: R43346The Patient Fin Clearance Rep is responsible for the entire scope of financial clearance activities for assigned patients before the scheduled appointment date. 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/ collecting patient liability estimate, restricting/redirecting out of network patient, and communicating patient financial responsibility. The Patient Fin Clearance Rep ensures patient financial responsibility is communicated with consistency, clarity and transparency to ensure patients understand the cost of services they receive, their insurance coverage and limitations, and their individual responsibility. Successful performance of job duties directly impacts health system goals of streamlining clinical operation work flows as well as improving revenue cycle operations and financial performance.Licensure, Certification, or Registration Requirements for Hire: N/ALicensure, Certification, or Registration Requirements for continued employment: N/AExperience REQUIRED:Minimum three (3) years of previous experience in a health care setting to include:Experience in commercial, managed care and governmental health insurance plans andOne (1) year experience in insurance plan authorization and referral requirements; or Medical billingPrevious experience using a personal computer and various software applications, including Microsoft, e-mail, etc.Strong customer service skills and patients/customers centered focus in a positive manner in all situationsExperience PREFERRED:Previous experience using GE-IDX Patient Registration or other medical billing/registration systemPrevious experience in ICD and CPT codingPrevious experience using medical terminologyEducation/training REQUIRED:High School Diploma or equivalentEducation/training PREFERRED:Post high school education in healthcare or medical billing courseworkIndependent action(s) required:Collects and updates patient demographic and insurance plan informationVerifies insurance plan eligibility and benefits using multiple system and web-based tools, as well as calling payer and patient as necessaryCalculates out-of-pocket liability and collects required deposits, co-pays, deductibles and outstanding balances from patient prior to serviceRefers patients to financial counselors when assistance needed to identify alternate payer source or establish payment planContacts in-house and community primary care physicians to secure PCP referral for consult and treatment as required by health planContacts health plan to secure prior authorization for procedures/testing as required by health planCoordinates peer-to-peer review between VCUHS physicians and health plan medical directors to secure prior authorization for servicesPrepares all forms required to obtain payment from third party payer for servicesDetermines when appropriate to apply additions/revisions to patient account and current visitMaintains thorough knowledge of commercial, managed care and governmental health care plansMaintains thorough knowledge of insurance plan authorization and referral requirementsSupervisory responsibilities (if applicable): N/AAdditional position requirements:May require work hours to periodically extend to 8:00 p.m. as necessary to resolve backlog or to contact patients for registration data.Age Specific groups served: AllPhysical Requirements (includes use of assistance devices as appropriate):Physical - Lifting 20-50 lbs.Activities: Prolonged sitting, Reaching (overhead, extensive, repetitive), Repetitive motion, Other: Prolong PC/keyboard usageMental/Sensory: Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking, Other: Concentrate/FocusEmotional: Fast pace environment, Steady pace, Able to handle multiple priorities, Frequent and intense customer interactions, Noisy environment, Able to adapt to frequent changeEEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.