Financial Clearance / Insurance Verification Specialist

Southwoods Health•Boardman, OH

27d•Onsite

About The Position

Financial Clearance / Insurance Verification Specialist Southwoods Health is hiring a Financial Clearance / Insurance Verification Specialist to work at The Southwoods Executive Centre in Boardman, Ohio. This position is responsible for accurately verifying patient insurances, confirming benefits and eligibility, ensuring an authorization is secured for the procedure to be performed, and calculating and communicating the patient responsibility to ensure timely payment will be made for the services rendered.

Requirements

Thorough understanding of financial clearance services on revenue cycle operations
Insurance verification experience, required
Familiarity with benefits and liabilities
Strong ethical and moral character references
Maintains professional demeanor at all times
Prioritization and time management

Responsibilities

Verify all insurance coverage, workers’ compensation insurance, accident insurance, and state programs and determine patient’s responsibility if applicable
Obtain or confirm precertification number is secured
Determine patient qualification for coverage by third-party payer and inform supervisor if an authorization isn’t secured within 72 hours of the scheduled procedure date
Completely and accurately document benefits, eligibility, and authorization for third-party payer before date of scheduled admission
Follow all federal, state, and regulatory guidelines to maintain compliance
Ensure patients are educated and prepared to make a deposit on any out-of-pocket expense
Stay abreast of insurance requirements for prior authorization and medical necessity
Maintain awareness of in and out of network status and ensure this is also communicated to the patient
Ensure all processes at responsible physician practice maintains compliance with all regulatory agencies
Perform other duties as assigned