Financial Clearance Specialist

Northwestern Medicine • Palos Heights, IL

245d

About The Position

The Financial Clearance Specialist reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

Requirements

• High School Diploma or equivalent.
• 2-3 years previous hospital billing, insurance follow-up, or customer service in a hospital setting.
• Excellent interpersonal, verbal, and written communication skills.
• Proficiency in computer data-entry/typing.
• Ability to read, write, and communicate effectively in English.
• Basic computer skills.
• Ability to type 40 wpm.
• Ability to multi-task.
• Customer service oriented.
• Excellent organizational, time management, analytical, and problem solving skills.

Nice To Haves

• Bachelors Degree.
• Additional language skills.
• Healthcare finance and/or healthcare insurance experience.
• Knowledge and experience in a healthcare setting, especially patient scheduling and/or registration.

Responsibilities

• Consistently practices Patients First philosophy and adheres to high standards of customer service.
• Responds to questions and concerns and forwards extraordinary issues to Team Lead or Operations Coordinator.
• Maintains patient confidentiality per HIPAA regulations.
• Provides exceptional customer service to consumers, establishing a positive first impression of Northwestern Medicine.
• Exceeds all consumer requests and alerts management of issues or concerns that require escalation.
• Correctly identifies and collects patient demographic information in accordance with organization standards.
• Responds to telephone inquiries and performs appropriate actions.
• Documents all actions taken in the appropriate software applications.
• Monitors admission/registration and scheduled surgeries flow of patient information through the revenue cycle.
• Serves as a resource to staff and patients for insurance related issues.
• Has a strong understanding of Medicare/Medicaid rules and regulations, and managed care products.
• Reviews patient electronic medical record for appropriate diagnosis and pre-treatment rendered.
• Consults with physicians and their assistants whenever questions arise to ensure timely approvals.
• Follows through and makes corrections in demographics and insurances as they are discovered.
• Monitors Referral In-Basket in EPIC to ensure work is consistently completed in a timely manner.
• Facilitates the pre-authorization of diagnostic exams between referring physicians and insurance carriers.
• Ensures all admissions, scheduled surgeries, and certain outpatient procedures are financially cleared.
• Interacts with various hospital departments and physicians' offices to effectively schedule and direct patients.
• Performs medical necessity checks as necessary for scheduled services.
• Informs patients of any issues with securing the financial account for their encounter.
• Provides training and education as needed.
• Manages work schedule efficiently, completing tasks and assignments on time.
• Participates in Quality Assurance reviews to ensure integrity of patient data information.
• Uses effective service recovery skills to solve problems or service breakdowns.
• Utilizes department and hospital policies and procedures to complete assigned tasks.
• Performs duties within the regulatory guidelines of the Fair Patient Billing Act and the Fair Debt Collection Act.

Benefits

• Wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being.

What This Job Offers

• Industry: Hospitals
• Education Level: High school or GED