Specialist Financial Clearance II

Trinity Health•Maywood, IL

3d•$19 - $30•Onsite

About The Position

The Financial Clearance Specialist II is responsible for supporting organizational and patient access objectives through advanced financial clearance, authorization, verification, and data analysis activities. This role utilizes specialized knowledge, critical thinking, and problem-solving skills to process and coordinate financial clearance for complex, high-dollar healthcare services, including surgical procedures, observation stays, inpatient admissions, and facility-based ancillary testing across multiple facilities and states. The Specialist researches, analyzes, and interprets operational and financial data to identify opportunities for process improvement, support leadership decision-making, and enhance patient experience and program efficiency. Responsibilities include performing complex insurance verification and authorization functions, developing and distributing analytical reports, monitoring key performance metrics, and providing actionable recommendations based on data trends and outcomes. Working across multiple areas of verification, including outpatient services, elective procedures, urgent admissions, and inpatient scheduling, the Specialist serves as a subject matter resource and peer influencer while ensuring compliance with federal, state, and local regulations, Trinity Health policies, and organizational standards for quality, confidentiality, and ethical conduct.

Requirements

High School Diploma or Equivalent
Two (2) to Five (5) years experience in area of expertise such as scheduling, financial clearance, or patient access
National certification in HFMA CRCR or NAHAM CHAA required within one (1) year of hire.
Must be proficient in the use of Patient Registration/Patient Accounting systems and related software systems

Nice To Haves

Associates Degree, preferred.
Comprehensive knowledge of scheduling with mastery in at least three (3) or more modalities and insurance verification processes with three (3) years scheduling experience in an acute care setting
Experience in complex facility based ancillary testing across multiple facilities/states
Strong knowledge of third-party and government payer billing and reimbursement guidelines as well as department performance standards and policies and procedures.

Responsibilities

Supporting organizational and patient access objectives through advanced financial clearance, authorization, verification, and data analysis activities.
Processing and coordinating financial clearance for complex, high-dollar healthcare services, including surgical procedures, observation stays, inpatient admissions, and facility-based ancillary testing across multiple facilities and states.
Researching, analyzing, and interpreting operational and financial data to identify opportunities for process improvement, support leadership decision-making, and enhance patient experience and program efficiency.
Performing complex insurance verification and authorization functions.
Developing and distributing analytical reports.
Monitoring key performance metrics.
Providing actionable recommendations based on data trends and outcomes.
Serving as a subject matter resource and peer influencer.
Ensuring compliance with federal, state, and local regulations, Trinity Health policies, and organizational standards for quality, confidentiality, and ethical conduct.