Senior Financial Clearance & Eligibility Specialist

Trinity Health Corp.; Ann Arbor (MI); In loco; USD 55.000 - 75.000; Tempo pieno

Descrizione del lavoro

Trinity Health Corp. in Michigan is seeking a Financial Clearance Specialist II to manage pre-service accounts' financial clearance and collections prior to service.

You will verify insurance, benefits, authorizations, and coordinate with multiple facilities for complex surgical and in-house services. The role requires 5+ years in financial clearance/authorization in acute care, strong knowledge of payer billing, and proficiency with patient registration/accounting systems.

Competenze

• Minimum five (5) years of financial clearance/authorization experience in an acute care setting.
• National certification in HFMA CRCR required within one (1) year of hire.
• Associate's degree in healthcare administration or related field preferred.

Mansioni

• Performs insurance eligibility/benefit verification using a variety of mechanisms and documents information in the EMR system.
• Determines need for appropriate service authorizations and coordinates with physicians and care teams.
• Informs patient/guarantor of liabilities and collects patient balances at pre-registration.
• Documents payments/actions in patient accounting systems and provides receipts.
• Validates medical necessity for Medicare and Non-Medicare cases to ensure clinical and financial clearance.
• Supports scheduling and ancillary departments for case clarification when needed.

Conoscenze

Insurance verification

Benefit validation

Pre-service clearance

Patient accounting systems

Eligibility/authorization experience

Formazione

High School Diploma or equivalent

Associate's degree preferred

Strumenti

EMR systems

EDI transactions

Payer portals

Descrizione del lavoro

Trinity Health Corp. in Michigan is seeking a Financial Clearance Specialist II to manage pre-service accounts' financial clearance and collections prior to service.

You will verify insurance, benefits, authorizations, and coordinate with multiple facilities for complex surgical and in-house services. The role requires 5+ years in financial clearance/authorization in acute care, strong knowledge of payer billing, and proficiency with patient registration/accounting systems.