Patient Financial Clearance Specialist I

Children's Hospital Medical Center; North Carolina; On-site; USD 26,000 - 32,000; Full time

Job summary

Cincinnati Children's is hiring for a Customer Service role on the South Campus, working full time in a fast-paced environment. You will efficiently obtain pre-authorizations for scheduled services and medications, verify insurance details, and communicate with families to confirm eligibility and referrals.

You will collaborate with Billing, Admitting, Outpatient departments, and Physicians Billing Service to ensure smooth authorizations.

Qualifications

• High school diploma or equivalent.
• No directly related experience.

Responsibilities

• Pre-Authorization- Efficiently obtain pre-authorizations for scheduled services and medications using medical records and systems. Collaborate with internal and external resources on authorization scenarios. Contact families before scheduled visits to confirm insurance eligibility and referrals with minimal stress. Collect/provide insurance-based estimates and adhere to registration workflows. Maintain a general understanding of billing processes.
• Productivity - Work independently and/or collaboratively with team to efficiently handle work volume and queues to meet or exceed productivity standards. Accurately collect/verify insurance information and demographics, obtaining insurance authorization and entering the information into the required systems.
• Collaboration- Serve as a liaison between Hospital/Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patient Financial Services, Utilization Review and other Cincinnati Children's departments. Multiple division support; cross trained in order to work insurance pre-authorization for multiple divisions.
• Problem Resolution - Initiate calls to appropriate parties both internal and external to resolve issues. Escalate to appropriate staff regarding system errors, recurring divisional problems/errors identified within work queues or reports.

Education

High school diploma or equivalent

Job description

Cincinnati Children's is hiring for a Customer Service role on the South Campus, working full time in a fast-paced environment. You will efficiently obtain pre-authorizations for scheduled services and medications, verify insurance details, and communicate with families to confirm eligibility and referrals.

You will collaborate with Billing, Admitting, Outpatient departments, and Physicians Billing Service to ensure smooth authorizations.