Financial Clearance Specialist

CommonSpirit Health • Phoenix, AZ

7d

About The Position

As a Financial Professional, you will apply financial expertise to support strategic goals and optimal fiscal health. Every day you will analyze financial data, interpret complex information, and communicate findings or recommendations to stakeholders, ensuring accuracy and compliance in financial processes. To be successful in this role, you will demonstrate strong analytical skills, meticulous attention to detail, and excellent communication abilities to guide informed financial decisions.

Requirements

• MINIMUM
• High School Diploma or GED
• One (1) year experience in electronic billing processes and proficiency with electronic data applications.
• Four (4) years physician billing/collection experience or other related healthcare provider claims experience in a high volume medical healthcare claim environment.
• AHCCCS/ Medicare/government Commercial payer experience
• HCFA 1500 billing experience
• Must have an aptitude for systems applications and be proficient in Excel and all Google/Microsoft Office products.
• Must have a working knowledge of claims payment laws, as well as medical terminology
• Must be a detail oriented problem-solver with good time management skills and the ability to work independently or as part of a team.
• In addition to possessing solid office and analytical skills, they must also be effective communicators so that they can resolve issues in a fast-paced environment.

Nice To Haves

• PREFERRED
• One (1) year experience in Physician front office to include registering patient demographics and insurance, and verifying eligibility

Responsibilities

• Prepares and submits claims to various insurance companies either electronically or by paper.
• Reconciles and ensures all electronic claim files are received and correctly processed by E-commerce and by the payers.
• Fully researches and performs follow up on any claim or payer edits via ETM views.
• Maintain productivity percentage at the rate established for the Fiscal Year goal.
• Acts as a highly skilled specialist and subject matter expert in EDI requirements and submission format.
• Ensures the accuracy of claims for reimbursement by gathering and processing information needed to complete medical insurance claims.
• Maintains average QA percentage at the rate established for the Fiscal Year goal.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees