Financial Clearance Specialist

Logan Health

3d•Remote

About The Position

Our Mission: Quality, compassionate care for all. Our Vision: Reimagine health care through connection, service and innovation. Our Core Values: Be Kind | Trust and Be Trusted | Work Together | Strive for Excellence. Join the Financial Clearance team! This position offers full-time remote work. To be eligible, you must reside in one of the following states: Arkansas, Arizona, Colorado, Florida, Hawaii, Idaho, Illinois, Indiana, Kansas, Michigan, Missouri, Montana, Minnesota, North Carolina, Ohio, Oregon, Tennessee, Texas, Virginia, Washington. Logan Health operates 24 hours per day, seven days per week. Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed. If you receive a job offer, please note all offers are contingent upon passing a pre-employment screening, which includes: Criminal background check, Reference checks, Drug Screening, Health and Immunizations Screening, Physical Demand Review/Screening. Logan Health is an Equal Opportunity Employer (EOE/AA/M-F/Vet/Disability). We encourage all qualified individuals to apply for employment. We do not discriminate against any applicant or employee based on protected veteran status, race, color, gender, sexual orientation, religion, national origin, age, disability or any other basis protected by applicable law. If you require accommodation to complete the application, testing or interview process, please notify Human Resources.

Requirements

2+ years of experience in registration, financial clearance, or patient financial services, with strong healthcare insurance knowledge.
Excellent understanding of insurance coverage, benefit verification, and reimbursement rules.
Strong math and analytical skills.
Proficiency with Microsoft Office Suite and the ability to learn new software.
Highly organized, detail-oriented, and able to set priorities.
Excellent verbal and written communication skills; comfortable interacting with a variety of audiences.
Strong interpersonal skills with professionalism, tact, and diplomacy.
Critical thinker; works well independently and as part of a team.
Commitment to confidentiality and team collaboration.

Nice To Haves

Associate’s or Bachelor’s degree.
Experience with managed care coverage, reimbursement, medical terminology, and medical coding.
Background in medical office or hospital setting.

Responsibilities

Verify insurance eligibility, benefits, and patient liability to prevent denials or penalties.
Accurately document insurance and payment information to optimize reimbursement and avoid write-offs.
Maintain up-to-date knowledge of insurance plans, contract requirements, and best practices for insurance verification.
Confirm and secure benefits coverage with insurance companies and employers; ensure demographic data is correct.
Cross-reference Medicare accounts and coordinate benefit statuses as needed.
Determine and process pre-certification or referral requirements per protocol.
Communicate with providers regarding out-of-network barriers and document accordingly.
Estimate and collect patient liability prior to service, following cash management policies.
Maximize collection of co-pays and other balances per department protocol.
Review and resolve accounts on hold to ensure timely billing.
Partner with the Authorization team to obtain payer authorizations and referrals.
Ensure compliance with HIPAA and all insurance process regulations.
Continue developing your skills to keep up with changes in insurance and reimbursement rules.
Maintain regular and consistent attendance as scheduled by department leadership.