Patient Financial Clearance Specialist — Billing & Eligibility

C999 UMass Memorial Health Care, Inc.; Worcester (MA); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Signing bonus available

Job summary

UMass Memorial Health Care in Worcester, MA is seeking a Financial Clearance Specialist responsible for assessing and verifying patient information for scheduled medical services, initiating contact with insurance to obtain eligibility, collecting payments, ensuring pre-certification, and guiding patients to financial counselors.

The role requires 4+ years in a business office with hospital revenue cycle experience, HS diploma with associate degree preferred, and familiarity with hospital

Qualifications

• Minimum High School Diploma, or G.E.D., business concentration preferred.
• Associate degree, or higher, preferred.
• Four plus (4+) years of experience within a business office setting, hospital revenue cycle preferred, Physician office or collection agency.
• Prior experience in a healthcare environment required.
• Working knowledge of personal computers and business office applications preferred.
• Familiarity with hospital computer systems is a plus.
• Knowledge of third party collections and reimbursement preferred.

Responsibilities

• Initiates contact with insurance companies to obtain eligibility, gather accurate patient billing information, and performs collections with outstanding accounts receivable.
• Estimates patient financial liability and answers inquiries regarding liability and variables involved.
• Receives and processes patient payments.
• Ensures pre-certification authorization or referral is in place prior to service.
• Refers patients to Financial Counselors or Business Office as needed.
• Reschedules appointments when necessary due to financial circumstances.
• Enters notes regarding financial clearance status in the system.
• Adheres to Financial Clearance Policy in all patient cases.
• Assess gaps in patient coverage to determine financial exposure.
• Be flexible to changing needs and reprioritize work as required.
• Performs other duties to ensure smooth department operation.

Skills

Revenue cycle experience

Healthcare environment

Education

High School Diploma or GED

Associate degree preferred

Job description

UMass Memorial Health Care in Worcester, MA is seeking a Financial Clearance Specialist responsible for assessing and verifying patient information for scheduled medical services, initiating contact with insurance to obtain eligibility, collecting payments, ensuring pre-certification, and guiding patients to financial counselors.

The role requires 4+ years in a business office with hospital revenue cycle experience, HS diploma with associate degree preferred, and familiarity with hospital