Revenue Cycle Specialist: Medical Clearance

Beth Israel Lahey Health; Exeter (NH); Sur place; USD 43 000 - 57 000; Plein temps

Résumé du poste

Beth Israel Lahey Health is seeking a Financial Clearance Associate to complete all financial clearance activities for outpatient services. You will verify insurance eligibility, determine medical necessity and authorization needs, and coordinate with departments to ensure compliant and timely approvals.

The role requires knowledge of CPT/HCPCS/ICD coding, strong Microsoft Office skills, and 1–3 years of related experience.

Qualifications

• High School diploma or GED required; associate degree preferred.
• 1-3 years related work experience required.
• Knowledge of CPT, HCPCS, ICD-9/ICD-10 coding; proficient in Microsoft Office.

Responsabilités

• Verify patient insurance eligibility for visits using online tools and payer contact.
• Identify payer medical necessity determinations before services; inform departments of outcomes.
• Determine authorization requirements and obtain approvals per payer protocols.
• Escalate issues promptly and coordinate with revenue cycle, leadership and clinical staff.
• Complete work queues, monitor productivity and assist with urgent/walk-in authorizations; refer to financial counselors as needed.
• Adhere to BIDMC policies and training; ensure compliance with laws and contracts.
• Identify trends and report operational, productivity and quality metrics.
• Perform other duties to support the department as needed.

Connaissances

CPT/HCPCS/ICD coding

MS Office

Formation

High School diploma or GED

Associate's degree preferred

Outils

Craneware software

Description du poste

Beth Israel Lahey Health is seeking a Financial Clearance Associate to complete all financial clearance activities for outpatient services. You will verify insurance eligibility, determine medical necessity and authorization needs, and coordinate with departments to ensure compliant and timely approvals.

The role requires knowledge of CPT/HCPCS/ICD coding, strong Microsoft Office skills, and 1–3 years of related experience.