Financial Clearance Specialist

UMass Memorial Health•Worcester, MA

About The Position

The Financial Clearance Specialist assesses and verifies patient information for scheduled medical services, including demographic, financial, and insurance details. The specialist collects copayments, deductibles, coinsurance, deposits, and other patient payments; provides service estimates when appropriate; and processes payments for current and past balances. The role focuses on collecting patient liabilities and resolving insurance and financial issues before services are rendered. It also serves as a front line for customer service, preregistration, and access to scheduled care. Appointments may be rescheduled when appropriate, including at a department leader’s direction due to financial circumstances. The position is non-exempt and scheduled Monday through Friday, 8:00 a.m. to 4:30 p.m., for 40 hours per week on the day shift. The stated hiring range is $20.94–$29.27 per hour based on a full-time schedule; final compensation varies with scheduled hours, experience, skills, qualifications, and internal equity. Part-time or reduced-schedule compensation is prorated. A signing bonus may be available, with eligibility confirmed during the interview process.

Requirements

High school diploma or GED required; a business concentration is preferred.
At least four years of experience in a business office setting; hospital revenue-cycle experience is preferred. Physician office or collection-agency experience is also identified.
Prior experience in a healthcare environment required.

Nice To Haves

Associate degree or higher.
Working knowledge of personal computers and business office applications.
Familiarity with hospital computer systems.
Knowledge of third-party collections and reimbursement.
Business concentration in high school or GED studies.

Responsibilities

Contact insurance companies to verify eligibility, obtain accurate patient billing information, and pursue collections on outstanding accounts receivable.
Estimate patient financial liability, including copayments, deductibles, coinsurance, and deposits, using accurate demographic and financial information; answer patient questions and explain liability variables.
Receive and process patient payments.
Ensure required precertification, authorization, or referrals are in place before services are rendered.
Refer patients to Financial Counselors or the Business Office as appropriate to their needs.
Reschedule appointments at a patient’s request or, with department leader guidance, when financial circumstances require postponement.
Enter clear and concise notes in the system regarding financial clearance status and communications.
Know, follow, and consistently apply job-related policies and procedures, including the Financial Clearance Policy.
Assess gaps in patient coverage to determine financial exposure before services are rendered.
Respond flexibly to changing situations and reprioritize work as needed.
Perform other duties as assigned or directed to support smooth department or unit operations.