Patient Financial Clearance Representative Senior - One Capital Square - Remote

Virginia Commonwealth University Health; États-Unis; À distance; USD 25 000 - 39 000; Plein temps

Résumé du poste

Virginia Commonwealth University Health is seeking a Senior Patient Financial Clearance Representative to ensure accurate patient data and eligibility verification prior to appointments. You will work across communications with patients, clinical staff, and providers to safeguard accurate registrations and timely financial clearance.

The role includes mentoring new staff, handling complex cases, and using EPIC to manage registration workflows.

Qualifications

• Minimum three years of experience in a health care setting.
• Experience with commercial, managed care, and government health insurance plans is preferred.
• Experience in insurance plan authorization and referral requirements is a plus.

Responsabilités

• Communicate effectively with patients, staff, and providers to coordinate services.
• Verify eligibility and benefits prior to outpatient visits.
• Update patient registration data accurately in EPIC and related systems.
• Assist with financial clearance and counseling as needed.
• Provide coaching and mentorship to new representatives.

Connaissances

Customer service

Registration accuracy

EPIC system

Communication

Mentoring

Formation

High School Diploma

Outils

EPIC Registration

Microsoft Office

Description du poste

Remote States: AL, AR, FL, GA, KS, KY, MD, MI, MO, MS, NC, OH, SC, TN, TX, VA, WV

The Patient Financial Clearance Representative Senior demonstrates strong customer service orientation while handling all business functions in an assigned area to secure the appropriate patient information; ensure that registration data is correct and accurate; validate insurance eligibility, enter information into appropriate systems, collects co-pay (if applicable), and assist with financial counseling and financial clearance, as necessary. This role performs all aspects of the Patient Financial Clearance rep position as needed. In addition, the Patient Financial Clearance Representative Sr. provides real time training when there are new representatives, providing troubleshooting guidance and mentorship.

Essential Job Functions

Communicates effectively with patients, clinical staff, and providers when the postponement of services is necessary due to lack of eligibility or benefits. Prioritizes and coordinates patient accounts that require completion of patient demographic, third party payer and visit data prior to the appointment date. Independently resolves missing or incorrect data elements, specifically for defined critical data set. Applies additions and revisions to patient’s EPIC account utilizing established registration policies and procedures. Determines appropriateness of applying plan additions or revisions to past and future scheduled visits and takes appropriate action. Contacts patient or guarantor by phone, portal, email, or mail and communicates in a professional and courteous manner as necessary to complete or update demographic, third party payer or visit data. Uses knowledge and accuracy in updating registration data according to established policies and procedures by consistently achieving an accuracy rate of 97% or greater on the EPIC Registration Audit Program Confirms eligibility and benefits of current health plan for assigned patients prior to scheduled outpatient visit date. Utilizes combination of on-line eligibility tool, health plan web-based sites, and telephone confirmation with health plan representative to determine current eligibility and benefits. If eligibility or benefit confirmation is unsuccessful after exhausting all available methodologies, contacts patient or guarantor by phone, email, or portal to communicate eligibility and benefit limitations and/or obtain new health plan data. May require ability to cancel or reschedule appointments when additional time is needed to confirm health plan eligibility and/or benefits to guarantee payment. Provides coaching and supports the development and acquisition of job-specific skills Ensures responsibility and visible commitment to diversity, equity, and inclusion programs/initiatives through collaboration and implementation of initiatives across the health system. Perform other duties as assigned and/or participates in special projects in order to support the mission of VCUHS and the Department.

Patient Population: Not applicable to this position.

Employment Qualifications

Required Education: High School Diploma or equivalent

Preferred Education: N/A

Licensure/Certification Required: N/A

Licensure/Certification Preferred: N/A

Minimum Qualifications: Required Qualifications: Minimum three (3) years of previous experience in a health care setting to include: Experience in commercial, managed care and governmental health insurance plans and One (1) year experience in insurance plan authorization and referral requirements; or medical billing

Other Knowledge, Skills and Abilities Required

Previous 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 situations.

Cultural Responsiveness

Demonstrates a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.

Other Knowledge, Skills and Abilities Preferred

Use of Patient Registration or other medical billing/registration systems, ICD and CPT coding, medical terminology

Working Conditions

General office environment. Prolonged periods of working alone.

Physical Requirements

Physical Demands: Lifting/ Carrying (0-50 lbs) Work Position: Sitting, Walking, Standing Additional Physical Requirements/ Hazards: Physical Requirements: Repetitive hand arm/hand movements Mental/Sensory - Emotional: Mental/Sensory: Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical Thinking Emotional: Steady-paced environment, Frequent and intense customer interactions, Able to adapt to frequent change

Compensation Range

$18.39 - $28.51 Actual salary offers will be based on several key factors to include relevant work experience, credentials, and qualifications.

EEO

Employer/Disabled/Protected Veteran

Who We Are

Inventing better care, day by day by discovery Sound outrageous? It absolutely is. Sound impossible? That’s never stopped us before. Sound like hard work, intense research, collaboration with experts around the world, sheer brainpower meets unrelenting willpower? That’s. Exactly. Right. We’ll do whatever it takes to offer the best in care and empower the best in quality of life. And it’s an approach that works — whether it’s a patient who undergoes a new, life‑saving procedure or a clinical researcher who finds promise in a new cancer treatment, exciting new medicine is happening at VCU Health.

We have it all:

• One college and four health sciences schools
• An academic medical center
• A Level I trauma center
• One of only two NCI‑designated cancer centers in Virginia
• The region’s only full‑service children’s hospital
• More than 800 physicians in 200 specialties
• With a community health center, dedicated research teams, facilities and valued partners in every field

Our medical teams are top notch. And we’re not too shy to boast of internationally known physicians, some recognized as the best in the country, top‑ranked local specialists and all‑around all-stars at every level.

From our very first years to our most recent advancements, we are driven to learn more, dig deeper, teach passionately and never rest in order to be a true leader in discovering what’s possible in health and recovery.

We are a comprehensive system of care and a pioneer of health. Read VCU Health Year In Review for more about our accomplishments.