Remote Financial Clearance II

Trinity Health•Livonia, MI

1d•$18 - $27•Remote

About The Position

The Financial Clearance II role covers the Iowa region and is responsible for ensuring Trinity Health pre-service accounts are financially cleared and secured before the date of service. The position handles complex, high-dollar services, including surgical, observation, and in-house services, and may work in outpatient verification, elective short procedure/inpatient verification, urgent admission verification, or scheduling. It obtains and verifies insurance information, validates benefits, secures authorizations, and collects payments before service, contributing to the patient experience and initiating the hospital billing process. The position works in a mission-driven health organization committed to improving community health and care while demonstrating reverence, commitment to people who are poor, justice, stewardship, and integrity. It requires adherence to Trinity Health policies, compliance requirements, applicable laws, and the organization’s Integrity and Compliance Program and Code of Conduct. The role operates in a collaborative, shared-leadership environment and performs other duties as assigned by the manager.

Requirements

High school diploma or equivalent combination of education and experience.
Three years of financial clearance experience in an acute care setting.
Comprehensive knowledge of financial clearance and insurance verification processes.
Experience processing financial clearance for complex services, including surgical services, observation, and in-house cases.
Strong knowledge of third-party and government payer billing and reimbursement guidelines, department performance standards, policies, and procedures.
Obtain HFMA CRCR and/or NAHAM CHAA national certification within one year of hire.
Ability to communicate and work with patients, physicians, physician office personnel, colleagues, direct patient care providers, and others to expedite registration and intake.
Proficiency with Patient Registration/Patient Accounting systems and related software.
Proficiency with Microsoft Office business software.
Ability to evaluate and investigate issues and determine effective resolutions that avoid negative financial impact.
Ability to work in a collaborative, shared-leadership environment.
Personal presence characterized by honesty, integrity, and caring, with the ability to inspire and motivate others in support of Trinity Health’s philosophy, mission, vision, goals, and values.
Ability to comply with Trinity Health policies and procedures and demonstrate honest, ethical, and professional behavior.

Nice To Haves

Superior customer service skills and etiquette.

Responsibilities

Financially clear patients for each visit type, admission type, and service area using the current Health Information System (HIS), and collect and document required demographic and financial information.
Activate registrations and complete discharges accurately and promptly.
Coordinate with Care Management regarding level of care, the Medicare Inpatient Only list, and required authorizations.
Coordinate with OR Scheduling on changes to dates of service, revisions, or cancellations and process them accordingly.
Analyze patient insurance, identify the correct plan, select the appropriate HIS insurance and plan options, document insurance order, and process recurring visits according to protocol.
Verify patient information with third-party payers; collect and document insurance referrals in HIS; and communicate authorization and referral requirements to patients and physician offices.
Identify when financial responsibility forms or electronic forms are needed, and escalate accounts according to the department Defer/Delay policy.
Screen outpatient visits for medical necessity and issue an Advanced Beneficiary Notice when appropriate for Medicare-primary outpatients.
Provide cost estimates; collect and document the Medicare Secondary Payer Questionnaire; and obtain information needed to bill third-party payers, such as workers’ compensation or motor vehicle insurers.
Maintain knowledge of regulatory requirements and guidelines in hospital and department Compliance Plans and ensure applicable Meaningful Use requirements are met.
Screen self-pay and out-of-network patients using approved technology, provide follow-up information, and refer patients to the RHM Medicaid Vendor or Financial Counselor as appropriate.
Initiate payment plans, obtain payments, explain applicable government and private funding programs, cash payment plans, and discounts to patients or families, and incorporate point-of-service collection processes into daily work.
Issue receipts and complete cash balance sheets in designated areas as applicable, using audits and controls to manage cash accurately and safely.
Meet or exceed department-specific productivity standards, collection targets, quality audit scores, accuracy and productivity standards, and registration and insurance verification standards.
Coordinate timely and accurate appointment scheduling across the region, applying scheduling protocols and insurance requirements and collecting and verifying pre-registration needs as needed.
Communicate and promptly escalate accounts of concern to management.
Comply with Trinity Health policies and procedures and maintain working knowledge of applicable federal, state, and local laws, regulations, compliance requirements, and organizational policies.
Perform other duties assigned by the manager.