Financial Clearance Specialist (REMOTE)

UMass Memorial Health•Worcester, MA

2d•Remote

About The Position

The Financial Clearance Specialist assesses and verifies patient demographic, financial, and insurance information for scheduled medical services. The role collects copayments, deductibles, coinsurance, deposits, and other patient financial liabilities; provides estimates when appropriate; and processes payments for current and past balances. The position focuses on collecting patient liabilities and resolving insurance or financial issues before services are rendered, supporting pre-registration, customer service, and access to care. It may reschedule appointments when appropriate under the guidance of a department leader. This position is remote and is scheduled Monday through Friday, 8:00 a.m. to 4:30 p.m., for 40 hours per week on the day shift. The role is non-exempt and represented by SHARE (State Healthcare and Research Employees). The listed hiring range is $20.94–$29.27, based on a full-time schedule; final compensation may vary based on scheduled hours, experience, skills, qualifications, and internal equity. Compensation for reduced schedules is prorated. A signing bonus may be available, with eligibility confirmed during the interview process.

Requirements

High school diploma or GED.
At least four years of experience in a business office setting; hospital revenue cycle, physician office, or collection agency experience is preferred within this requirement.
Prior experience in a healthcare environment.
Ability to verify patient demographic, financial, and insurance information and assess patient financial liability.
Ability to communicate with patients about financial liability and explain relevant variables.
Ability to adapt to changing situations and reprioritize work as needed.

Nice To Haves

Business concentration in high school or equivalent education.
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.
An equivalent combination of education and experience may be substituted for the listed requirements when it provides proficiency in the areas of responsibility, unless certification, licensure, or registration is required.

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 precertification, authorization, and/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, concise notes about financial clearance status and related communications in the system.
Understand and follow job-related policies and procedures, consistently applying the Financial Clearance Policy to patient cases.
Assess gaps in patient coverage to determine financial exposure before services are rendered.
Respond flexibly to changing situations and reprioritize work as necessary to meet current needs.
Perform other duties as assigned or directed to support smooth department or unit operations.