Financial Clearance Analyst Full Time 40 hours

Bristol Hospital Group•Bristol, CT

About The Position

At Bristol Health, the Financial Clearance Analyst supports compassionate, quality patient care by ensuring scheduled services are financially cleared in advance. Under the direction of the Manager of Pre-Service and Financial Clearance, this position handles patient authorization, insurance verification, and validation of medical necessity. The analyst coordinates with provider practices, hospital departments, and revenue cycle teams to meet payer requirements, support appropriate billing, and proactively address denials. The role may also back up the Financial Counselor team with Notice of Admission and Financial Assistance activities.

Requirements

One of the following education and experience combinations: a bachelor's degree and at least 1 year of revenue cycle experience; an associate degree and at least 2 years of patient access, financial clearance, or financial counselor experience; or a high school diploma and at least 5 years of patient access, financial clearance, or financial counselor experience.
Familiarity with medical and insurance terminology.
Knowledge of payer contracts, regulations, and guidelines, as well as state and federal laws relating to billing, collections, and patient access procedures.
Ability to ensure quality and integrity of assigned work and meet productivity standards.
Patient-centric approach and ability to answer questions and provide information professionally.
Ability to work collaboratively and demonstrate teamwork and cooperation.
Effective oral, written, and interpersonal communication skills.
Problem-solving skills and ability to translate data into actionable steps.
Ability to read, understand, interpret, and analyze payer requirements.
Ability to work independently and take initiative.
Customer service, organizational, analytical, and communication skills.
Ability to multitask while working independently.
Strong organizational skills and systems aptitude.

Nice To Haves

Experience with payer portals and payer requirements.

Responsibilities

Obtain pre-certification approvals before services and submit pre-authorization requests to payers.
Follow up with payers to ensure timely authorization decisions.
Maintain accurate records and reports of pre-certification requests, approvals, and denials.
Work assigned worklists and submit authorization information according to payer requirements.
Coordinate authorization follow-up with provider practices and hospital departments in accordance with established policies.
Collaborate with revenue cycle teams and participate in monthly meetings to review payment and denial trends.
Coordinate with provider practices and hospital departments to support timely scheduling of patient procedures.
Respond to patient and insurance inquiries and provide Good Faith Estimates when required.
Perform post-service reconciliations and denial follow-up tasks.
Back up the Financial Counselor team in supporting Notice of Admission and Financial Assistance activities.
Follow applicable policies and procedures, including HIPAA requirements and state and federal regulations.
Perform other duties as assigned.