Financial Clearance Representative I/II
About The Position
The Financial Clearance Representative helps patients access care by addressing insurance coverage, authorizations, and financial requirements before services are delivered. The role connects patients, healthcare providers, insurance companies, and internal teams to support timely access to care and help prevent claim denials. Candidates may be considered for either level depending on their experience and qualifications. The Representative I starting annual salary is $44,560, and the Representative II starting annual salary is $49,841. The posting states that each salary can include a comprehensive benefits package. At level II, the role may also involve managing complex authorization issues, preparing clinical documentation and letters of medical necessity, coordinating peer-to-peer reviews, supporting denial prevention and resolution, training team members, reviewing reports for process improvements, and assisting with projects and operational initiatives.
Requirements
- Financial Clearance Representative I: High school diploma or high school equivalency diploma and one year of full-time experience in pre-certifications and follow-up procedures or a related field; alternatively, successful completion of a Patient Access Representative traineeship at Roswell Park.
- Financial Clearance Representative II: High school diploma or high school equivalency diploma and three years of full-time experience in authorization and follow-up procedures or a related field; alternatively, two years of full-time experience in Financial Clearance and/or Patient Access within Roswell Park's Financial Clearance Department.
- Experience in insurance verification, authorizations, patient access, revenue cycle, healthcare administration, or a related healthcare setting.
- Knowledge of medical insurance plans, payer requirements, and pre-authorization processes.
- Strong problem-solving and critical-thinking skills.
- Excellent communication and customer service abilities.
- Ability to manage multiple priorities while maintaining accuracy and attention to detail.
- Comfort working with electronic systems, documentation, and reporting tools.
- Collaborative approach and ability to build strong working relationships across departments.
- Degrees, where applicable, must be conferred by an accredited or otherwise recognized institution.
Nice To Haves
- Previous experience obtaining authorizations or pre-certifications.
- Experience with insurance denials, appeals, or payer communications.
- Knowledge of hospital, physician billing, or oncology-related workflows.
- Experience preparing clinical documentation to support authorization requests.
- Experience training, mentoring, or supporting other team members.
- Strong understanding of healthcare reimbursement processes and regulatory requirements.
Responsibilities
- Verify insurance coverage and benefits for new and existing patients.
- Ensure patient demographic, insurance, and provider information is accurate and up to date.
- Obtain referrals, pre-certifications, and authorizations required for services and treatments.
- Communicate with insurance companies to support timely approvals and coverage determinations.
- Serve as a resource for clinical teams on insurance and authorization requirements.
- Investigate and resolve coverage issues that may affect patient care or billing.
- Research denied services and assist with appeals and follow-up.
- Coordinate with patient accounting, physician billing, admissions, and clinical teams to support financial clearance.
- Maintain accurate documentation and records related to authorizations and insurance verification.
- Monitor work queues, reports, and system activity to support timely processing and quality outcomes.
- At level II, manage more complex authorization and insurance-related issues.
- At level II, prepare clinical documentation and letters of medical necessity.
- At level II, coordinate peer-to-peer reviews between providers and insurance representatives.
- At level II, support denial prevention and resolution efforts.
- At level II, train and mentor team members.
- At level II, review reports to identify process improvement and efficiency opportunities.
- At level II, assist with special projects, system maintenance, and operational initiatives.
Benefits
- Comprehensive benefits package supporting health, wellness, and the future.
- Opportunities for professional growth and career advancement.
- Ongoing learning and development opportunities.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
