Financial Clearance Specialist

Job Number: 26-04496

Progress on your journey to success! ECLARO is currently recruiting for a Financial Clearance Specialist in the Chicago, IL area for one of our clients.

ECLARO’s client is a leading provider of healthcare workforce software and solutions. If you’re up to the challenge, then take a chance at this rewarding opportunity!

Responsibilities:

Consistently practices Patients First philosophy and adheres to high standards of customer service. This includes setting an example to peers, coworkers, etc. by fostering a team atmosphere

Responds to questions and concerns. Forwards, directs and notifies Team Lead or Operations Coordinator of extraordinary issues as necessary.

Maintains patient confidentiality per HIPAA regulations.

Specific Responsibilities

• Provides exceptional customer service to consumers which establish a positive first impression of Client. 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 action(s).

• Documents all actions taken in the appropriate software applications.

• Monitors admission I registration and scheduled surgeries' now 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. Is knowledgeable of current contracted and non-contracted healthcare insurance plans. Reviews patient electronic medical record for appropriate diagnosis and pre-treatment rendered. Has thorough understanding and working knowledge of CPT and 'CD-IO coding. Consults with physicians and their assistants whenever questions arise to insure timely approvals.

• Follows through and makes corrections in demographics and insurances as they are discovered. Data entry accuracy is imperative in this position.

• Monitors Referral In-Basket in EPIC to insure work is consistendy completed in a timely manner. This involves watching for future test requests to come due and then pre-authorized within the time frame specified by the insurance carrier and the patient notified

• Facilitates the pre-authorization of diagnostic exams, between referring physicians and insurance carriers, through the use of online tools, work lists, and direct phone calls as necessary to ensure maximized patient benefits

• Insures all admissions, scheduled surgeries, and certain outpatient procedures are financially deared, to allow for maximum and timely reimbursement to the hospital.

• Interacts with various hospital departments and physician's offices to effectively schedule and direct patients through the NMHC systems in a patlent/customer friendly manner.

• Performs medical necessity checks as necessary for scheduled services, communicates options to patient if appointment fails.

• Informs patients of any issues with securing the financial account for their encounter and completes out-of- pocket estimations as requested by patients

• Provides training and education as needed

• Manages work schedule efficiently, completing tasks and assignments on time

• Participates in Quality Assurance reviews to insure integrity of patient data information uses effective service recoveß' skills to sdve problems or service breakdowns when they occur. Utilizes departrnent 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

• Other duties as assigned

Required:

High School Diploma or equivalent

2-3 years previous hospital billing, insurance follow-up, Or customer service in a hospital setting.

Proficiency in computer data-entry/typing

Basic Computer Skills

Preferred:

Bachelor's Degree preferred.

Additional language skills.

Healthcare finance and/or healthcare insurance experience

Knowledge and experience in a healthcare setting, especially patient scheduling and/or registration

The Financial Clearance Specialist identifies and minimizes financial risk to the system, promotes accuracy and timeliness of data processing and maintains customer services objectives by obtaining and verification of patient demographic, clinical data/orders, financial and insurance information. Initiates financial account processes and educates patients regarding hospital policies, procedures, expectations and financial liabilities as needed.

Provides outstanding and professional Customer Service to all internal and external customers.

Shift: Day 5x8-Hour (08:00 - 17:00); Duration: 12 weeks

Pay Rate: $28.66/Hour

If hired, you will enjoy the following ECLARO Benefits:

• 401k Retirement Savings Plan administered by Merrill Lynch
• Commuter Check Pretax Commuter Benefits
• Eligibility to purchase Medical, Dental & Vision Insurance through ECLARO

Equal Opportunity Employer: ECLARO values diversity and does not discriminate based on Race, Color, Religion, Sex, Sexual Orientation, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status, in compliance with all applicable laws.