Financial Clearance Analyst
About The Position
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. The Financial Clearance Analyst is responsible for the financial clearance of complex patient authorizations, including insurance verification, price estimation, and validation of medical necessity for services. In addition, is accountable for coordinating the activities of the patient account from the point of scheduling through account clearance. Formulates solutions to respond and resolve non-clinical customer requests, issues and problems, while meeting the changing demands and priorities in a hospital environment. Works closely with the patients, families, outside departments and third party payers to ensure compliance to all authorization and medical necessity guidelines in order to protect the patient and the Hospital from unnecessary financial loss. EEO/AA/Disability/Veteran
Requirements
- High school graduate or GED required with work in healthcare or business preferred. Associate Degree preferred. CRCS or equivalent certification for Access Professionals required or in process (within an 18 months of hire).
- Two (2) to three (3) years of work experience with insurance authorization/verification of benefits, revenue cycle functions, hospital/physician offices, or related areas preferred.
- CRCS or equivalent certification for Access Professionals required or in process (within an 18 months of hire).
- Strong organizational skills and ability to prioritize tasks. Strong interpersonal skills and ability to build rapport with a wide variety of individuals. Knowledge of payer reimbursement processes and insurance terminology. Basic understanding of diagnostic testing and procedure codes (CPT, HCPCS, ICD-9-CM/PCS, and ICD-10-CM/PCS coding, etc.). Excellent verbal and written communication skills including the ability to communicate with physician providers. Intermediate working knowledge/understanding of medical terminology and disease process. Expert knowledge of Microsoft Office, Word, and Excel.
Responsibilities
- Collects, validates and accurately documents patient insurance and benefits information and is fully knowledgeable about all aspects of insurance verification requirements.
- Obtains prior authorizations from third-party payers in accordance with payer requirements.
- Maintains professional approach at all times when communicating with patients, co-workers, and payer representatives to ensure a positive and professional experience.
- Performs other duties as assigned by Supervisor.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Industry
Religious, Grantmaking, Civic, Professional, and Similar Organizations
Education Level
Associate degree
Number of Employees
5,001-10,000 employees
