Financial Clearance Specialist PRN As Needed

Trinity Health•Boise, ID

2d•Remote

About The Position

Position Purpose: Saint Alphonsus Health System is hiring for our Financial Clearance team. This position works on an as needed basis during the week (Monday-Friday). The Financial Clearance Specialist obtains and/or verifies demographic, clinical, financial and insurance information in the process of pre-registering and financially clearing patients for service delivery, including the entry of patient/guarantor information in the patient accounting system. The Pre-Service Specialist is also responsible for insurance eligibility / benefit verification, pre-certification / authorization, referral clearance and financial education on designated cases. Our ideal candidate has experience with EPIC, has worked in healthcare, and is local to the Treasure Valley in Idaho. Position Highlights and Benefits: Schedule Information: Position is scheduled as needed based on the needs of the team Monday – Friday during traditional office hours. Hours are subject to change. Position is remote (work from home); however, there is required in-person training during initial orientation in Boise, ID. PRN position is not eligible for benefits.

Requirements

High school diploma or equivalent.
Past work experience of at least 2 years within healthcare and/or payer environment performing patient access and/or customer service activities.
National certification in HFMA CRCR or NAHAM CHAA required within one (1) year of hire.

Nice To Haves

Associate degree or an equivalent combination of education and experience.
Data entry skills (50-60 keystrokes per minute).
Working knowledge of medical terminology desirable.

Responsibilities

Work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles.
Ensures patient safety by authenticating patient identity throughout all essential functions.
Meets or exceeds established customer service, productivity and quality standards in all essential functions.
Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence.
Performs activities that relate to pre-registration and financial clearance for multiple patient types and support coverage of other departmental divisions.
Responsible for pre-registering the patient for upcoming visit(s).
Validates, obtains and enters demographic, clinical, financial, and insurance information into the patient accounting system.
Performs insurance eligibility/benefit verification, utilizing a variety of mechanisms and documenting information within the patient accounting system.
Determines need for appropriate service authorizations and will contact the physician and Case Management/Utilization Review personnel, as necessary.
Informs patient/guarantor of their liabilities and collects appropriate patient liabilities.
Calculates patient liabilities and provides financial education, referring the patient to financial counseling, as required.
Validates medical necessity (LCD/NCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance.
May serve as relief support, if the work schedule or workload demands assistance to departmental personnel.
May also be chosen to serve as a resource to train new employees.
Must be able to sit or stand for extended periods of time and use a telephone headset.
Completion of regulatory/mandatory certifications and skills validation competencies preferred
Working knowledge of medical terminology desirable.
Basic computer skills are required.
Excellent communication (verbal and written) and organizational abilities.
Must be comfortable operating in a collaborative, shared leadership environment.
Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.