Financial Clearance Specialist / Scheduler – Insurance Pre-Authorization

Financial Clearance Specialist / Scheduler – Insurance Pre-Authorization

Requirements

• Problem Solving (Novice): Uses critical thinking and process improvement i.e. coaches and mentors development of problem statement, describes current state, identifies root causes, creates future state, coaches and mentors development of solutions and action plans with a sustainability plan. Applies appropriate tools to address issues.
• Data Entry (Novice): The ability to transcribe information from the original source into an electronic system according to written and verbal instructions efficiently and accurately.
• Customer Service (Novice): A continuing focus on the needs and requirements of customers, anticipating their needs, remaining sensitive to customers while performing services for them, responsive to customer needs.
• Insurance Regulatory Knowledge (Intermediate): Demonstrates knowledge of the appropriate rules and regulations for insurance policies, claims, payment and coverage. Ability to interpret and explain rules and regulations that are ambiguous or unclear.

Responsibilities

• Obtains certification from insurance companies for all office visits.
• Verifies insurance information and registers cases in tracking system.
• Evaluates patient assets and liabilities to determine ability to pay.
• Reviews alternatives to admission and guides patient in applying for financial assistance.
• Completes pre-certification, credit applications, and other necessary paperwork.
• Performs investigative and follow-up work relating to reimbursement issues.
• Performs tasks to support and obtains pre-certifications from insurance companies.

Preferred Qualifications

No preferred qualifications provided.