Senior Financial Clearance Specialist

Ensemble Health Partners•Work at Home - Ohio - Other, OH

About The Position

The Financial Clearance Senior Specialist performs advanced clearance activities for complex cases and serves as a resource for escalated issues. This position ensures adherence to regulatory and payer requirements while supporting revenue cycle objectives through accurate and timely clearance and proactive financial engagement. Conducts detailed reviews of patient accounts to identify and resolve complex insurance issues. Addresses high-cost or specialized services requiring advanced knowledge of payer rules. Collaborates with clinical and scheduling teams to address barriers impacting clearance. Provides training and guidance to less experienced team members on processes and compliance. Mentors colleagues to build expertise and supports onboarding and ongoing development initiatives. Serves as a subject matter expert for financial clearance processes and creates and updates standard operating procedures to ensure consistency and compliance. Monitors changes in payer requirements and updates internal procedures accordingly. Prepares reports on clearance outcomes and trends for leadership review. Oversees complex point-of-service collection efforts and initiates outbound calls for high-dollar or escalated financial discussions with patients.

Requirements

Advanced clearance activities for complex cases
Resource for escalated issues
Adherence to regulatory and payer requirements
Accurate and timely clearance
Proactive financial engagement
Detailed reviews of patient accounts
Identify and resolve complex insurance issues
Address high-cost or specialized services requiring advanced knowledge of payer rules
Collaborate with clinical and scheduling teams
Address barriers impacting clearance
Provide training and guidance to less experienced team members
Mentor colleagues to build expertise
Support onboarding and ongoing development initiatives
Subject matter expert for financial clearance processes
Create and update standard operating procedures
Monitor changes in payer requirements
Update internal procedures accordingly
Prepare reports on clearance outcomes and trends
Oversee complex point-of-service collection efforts
Initiate outbound calls for high-dollar or escalated financial discussions with patients

Responsibilities

Performs advanced clearance activities for complex cases.
Serves as a resource for escalated issues.
Ensures adherence to regulatory and payer requirements.
Supports revenue cycle objectives through accurate and timely clearance and proactive financial engagement.
Conducts detailed reviews of patient accounts to identify and resolve complex insurance issues.
Addresses high-cost or specialized services requiring advanced knowledge of payer rules.
Collaborates with clinical and scheduling teams to address barriers impacting clearance.
Provides training and guidance to less experienced team members on processes and compliance.
Mentors colleagues to build expertise and supports onboarding and ongoing development initiatives.
Serves as a subject matter expert for financial clearance processes.
Creates and updates standard operating procedures to ensure consistency and compliance.
Monitors changes in payer requirements and updates internal procedures accordingly.
Prepares reports on clearance outcomes and trends for leadership review.
Oversees complex point-of-service collection efforts.
Initiates outbound calls for high-dollar or escalated financial discussions with patients.