"Alerted.org

+ Remote: Yes

+ Area of Interest: Patient Services

+ FTE/Hours per pay period: 1.0

+ Department: Financial Clearance

+ Shift: Monday-Friday, 8am-4:30pm

+ Job ID: 170906

Overview

The Financial Clearance Coordinator is responsible for coordinating the staffing and workload for the financial clearance process. Responsible to assure that Financial Clearance is completed for both scheduled and nonscheduled appointments. The coordinator is responsible for (but not limited to) verifying eligibility, benefits, referral and authorization requirements in addition to obtaining referrals and authorizations as necessary. The coordinator will also be responsible for researching appointments to ascertain scheduled services as well as identifying the appropriate procedures codes for said services. Financial Clearance will also include financial work-up; financial collection over the phone or asking the patient to pay a specified amount prior to or on the date of service; communicating pertinent information to the patient financial counselors. Serves as a liaison between the patient, referring physician and insurance plan to ensure that all services are financially cleared several days in advance to the date of service.

Hours: Monday-Friday 8am-4:30pm

Why UnityPoint Health?

At UnityPoint Health, you matter. We’re proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row for our commitment to our team members.

Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in.   Here are just a few:

+ Expect paid time off, parental leave, 401K matching and an employee recognition program .

+ Dental and health insurance, paid holidays, short and long-term disability and more. We even offer pet insurance for your four-legged family members.

+ Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance to help you grow your family .

With a collective goal to champion a culture of belonging where everyone feels valued and respected, we honor the ways people are unique and embrace what brings us together.

And, we believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience.

Find a fulfilling career and make a difference with UnityPoint Health.

Responsibilities

Financial Clearance Coordination

+ Responsible to provide support and knowledge for the financial clearance team members assigned

+ Assist leadership in recommending, maintaining and approving appropriate staffing levels and administering the following: staff orientations, ongoing education programs, and development courses in all areas of responsibility

+ Financial Clearance Coordinator will be subject matter expert by assisting with providing oversight, coach and mentor team members, and provides recommendation on workflow

+ Provides guidance for use of departmental policies, procedures and protocols to evaluate and determine the best alternative for the patient as it pertains to the all aspects of Financial Clearance

+ Leading all aspects of financial clearance to enable complete, accurate, and timely hospital billing—maximizing collectable and minimizing uncollectible accounts

+ Maintaining a system of data reporting that provides timely and relevant information to all employees with respect to financial clearance responsibilities

+ Supervises process of admission notification and informing Utilization Review staff of authorization information to insure timely concurrent review

+ Ensuring the quality and reliability of Financial Clearance staff

+ Demonstrates subject matter expertise with insurance requirements

+ Actively assists department personnel with their duties as time permits or need arises

+ Readily identifies work that needs to be performed and completes it without needing to be told

+ Establishes and adheres to customer service standards for the department

Financial Clearance

+ Works collaboratively with physician practice personnel as necessary to assure that CPT code is correct for procedure ordered and is authorized when necessary

+ Initiates pre-certification process with physicians, PHO sites or insurance companies and obtains pre-cert/authorization numbers and other pertinent information that secures reimbursement of account

+ Completes eligibility check though electronic means or via phone contact with insurance carriers or other agencies and when necessary/requested provide initial clinical documentation

+ Perform follow-up calls as needed until verification/pre-certification process is complete

+ Thoroughly documents information and actions in all appropriate computer systems

+ Works with insurance companies to obtain retroactive authorization when not obtained at time of service

+ Works with insurance companies, providers, coders and case management to appeal denies claims

+ Collaborating with the central billing office, medical records, and information systems for all communications and information gathering activities

+ Follows EMTALA, HIPAA, payer and other regulations and standards

Qualifications

+ Two years of experience in a hospital patient access/patient accounts department, medical office/clinic or insurance company required

+ Requires experience interacting with patients and working knowledge of third-party payers and collections

+ Prior experience with verification, pre-certification and payer benefit and eligibility systems required

+ Knowledge of ICD coding and CPT codes is preferred

+ Knowledge of medical and insurance terminology required