Financial Clearance Representative Lead
About The Position
The Financial Clearance Representative Lead completes the financial clearance process and helps create patients’ first impression of Allina Health’s services. The role explains financial responsibilities clearly to patients, guarantors, and family members, and works with medical staff, nursing, ancillary departments, insurance payers, and other external parties to help patients obtain healthcare and financial services. The representative serves as a departmental subject matter expert and coaches experienced staff on financial clearance activities. This position performs standard and enhanced financial clearance work, including collecting information for pre-registration, verifying insurance coverage and benefits, obtaining authorizations, providing price estimates and financial counseling, and completing admission-related reviews and notifications where assigned. The lead also coordinates team activities, assigns and oversees daily work, supports staff development, reviews complex accounts, and helps identify and resolve workflow or performance issues. The position may include special projects and other assigned duties. The role is fully telecommutable from anywhere within the United States, subject to UnitedHealth Group’s Telecommuter Policy. The stated schedule is Monday through Friday, 7:00 a.m. to 3:30 p.m. CST. The hourly pay range is $20.00–$36.00, based on full-time employment.
Requirements
- At least 4 years of experience with insurance and/or benefit verification activities in healthcare business office or insurance operations.
- At least 1 year of experience as a Financial Clearance Representative.
- Ability to work Monday through Friday, 7:00 a.m. to 3:30 p.m. CST.
- Must be at least 18 years of age.
- Excellent customer service skills.
- Excellent written and verbal communication skills.
- Demonstrated ability to work in fast-paced environments.
- Telecommuters must adhere to UnitedHealth Group’s Telecommuter Policy.
- Must pass a drug test before beginning employment.
Nice To Haves
- Associate’s or vocational degree in Business Administration, Health Care Administration, Public Health, or a related field of study.
- Experience working with clinical staff.
- Previous experience working in outpatient and/or inpatient healthcare settings.
- Experience working in clinical documentation.
- Previous experience working with a patient’s clinical medical record.
Responsibilities
- Interview patients and collect and record information needed for patient pre-registration.
- Educate patients about applicable policies, including Patient Rights, HIPAA information, treatment consents, and visiting hours.
- Verify insurance eligibility, complete automated eligibility verification when applicable, and document information in Epic.
- Confirm that health insurance is active and covers the patient’s procedure.
- Review insurance benefits for the patient’s upcoming visit or stay, including coverage, effective dates, limitations, requirements, and patient liabilities.
- Provide proactive price estimates and help patients understand their financial responsibilities.
- Inform patients and families with inadequate coverage about government and financial assistance programs, and refer patients to financial counseling.
- Review patient visit information to determine authorization needs, apply payer-specific criteria, and obtain authorization to clear accounts before service where possible.
- Ensure initial and subsequent authorizations are obtained in a timely manner.
- Mentor and coach less experienced team members on revenue cycle processes, payer and policy issues, and other role-related matters.
- Complete enhanced financial clearance activities, which may include hospital admission reviews and admission/discharge notifications, and expanded benefit reviews for complex or high-dollar procedures.
- Provide financial counseling, evaluate assistance program eligibility, complete applications, assess whether services may need to be delayed or canceled, and escalate as needed.
- Work on special projects and non-standard workflows when assigned.
- Coordinate Financial Clearance team activities by assigning daily work and providing staff oversight and leadership.
- Work with the department Supervisor to set standards and develop and execute improvement plans.
- Alert the Supervisor to backlogs and suggest ways to resolve them.
- Communicate issues requiring management attention and identify staff, process, or performance improvement needs to the Supervisor.
- Review and resolve complex accounts requiring advanced expertise and critical thinking.
- Participate in employee orientation and training, and provide feedback to leadership.
- Complete daily accuracy reports and quality assurance reviews of patient accounts as directed.
- Provide backup coverage for departmental work as assigned.
- Perform other duties as assigned.
Benefits
- Paid time off accrued beginning with the first pay period, plus 8 paid holidays.
- Medical plan options and participation in a Health Spending Account or Health Savings Account.
- Dental insurance.
- Vision insurance.
- Life and AD&D insurance.
- Short-term disability coverage.
- Long-term disability coverage.
- 401(k) savings plan.
- Employee Stock Purchase Plan.
- Education reimbursement.
- Employee discounts.
- Employee Assistance Program.
- Employee Referral Bonus Program.
- Voluntary benefits, including pet insurance, legal insurance, and long-term care insurance.
- Performance rewards and incentive and recognition programs.
- Comprehensive benefits package, subject to eligibility requirements.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
