Patient Financial Clearance Representative - One Capital Square - Remote

VCU Health; Richmond (VA); Remote; USD 24,000 - 36,000; Full time

Benefits offered by this job

Remote work

Job summary

VCU Health seeks a Patient Financial Clearance Representative to manage the full scope of financial clearance for patients prior to appointments. Responsibilities include verifying insurance, calculating patient liability, and coordinating referrals and authorizations.

The role requires healthcare experience, strong customer service, and familiarity with commercial, managed care, and governmental plans. This position is remote with some on-site requirements in Richmond, VA.

Qualifications

• 3+ years experience in a healthcare setting with commercial, managed care and government health insurance plans.
• Experience with insurance plan authorization and referrals.
• Strong customer service focus and patient-centered approach.

Responsibilities

• Handle financial clearance for patients before scheduled appointments.
• Verify insurance eligibility and health plan benefits.
• Calculate out-of-pocket liability and collect deposits/co-pays/deductibles.
• Coordinate referrals and prior authorizations with health plans and PCPs.
• Refer patients to financial counselors as needed and assist with payment plans.

Skills

Healthcare experience

Customer service

Insurance knowledge

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

Patient Financial Clearance Representative - One Capital Square - Remote### Patient Financial Clearance Representative - One Capital Square - RemoteApply: Richmond, VA: Remote: Full time: Posted Today: R47686\\*\\*\\*Approved Remote States: AL, AR, FL, GA, KS, KY, MD, MI, MO, MS, NC, OH, SC, TN, TX, VA, WV\\*\\*\\* The 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 changeCompensation Range: $17.50 - $26.39 Actual salary offers will be based on several key factors to include relevant work experience, credentials, and qualifications.Compensation Range: $17.50 - $26.39 Actual salary offers will be based on several key factors to include relevant work experience, credentials, and qualifications.