Financial Clearance Representative III

Job Description

At Tri Health, our Financial Clearance Representatives play a critical role in ensuring every patient begins their care journey with clarity, compassion, and confidence. You are at the front line of financial advocacy—helping patients understand coverage, removing barriers to care, and contributing directly to a seamless, trusted healthcare experience.

Work from home

8:30 AM - 5:00 PM, M-F

We offer competitive shift differentials, opportunities for professional growth, and a comprehensive benefits package that may include medical, dental, vision, paid time off, retirement savings plans, and tuition reimbursement.

• PRN positions not eligible for Tri Health benefits

• High School Degree in Medical terminology course or equivalent knowledge
• Knowledge of Medical Terminology
• Insurance vocabulary and processes
• Government and Non-government third party benefits and coverage rules
• Understanding of the impact financial clearance services has on revenue cycle operations and financial performance
• 1-2 years experience Customer Service Healthcare Dedication to treating both internal and external constituents as clients and customers Maintaining a flexible customer service approach and orientation that emphasizes service satisfaction and quality
• Background in managed care or patient billing
• 1-2 years experience Technical Healthcare
• Must have one year experience in insurance verification or precertification experience
• Experience with automated patient account system or online verification systems

This position is responsible for verifying patient insurance, confirming benefits eligibility, performing authorization and pre-certification, calculating and estimating patient liability, and/or notification as required by third party coverage providers. Purpose of this job is to verify that Tri Health patient insurance information is accurate and up to date so payment will be received for services rendered. Additionally, this position requires the knowledge to review medical records obtaining information such as diagnosis, prior treatment, sign and symptoms, medication and other medical information to submit requests for authorizations for surgery, testing or treatment.

• Climbing – Rarely
• Concentrating – Consistently
• Continuous Learning – Frequently
• Hearing:
  Conversation – Consistently
• Hearing:
  Other Sounds – Rarely
• Interpersonal Communication – Consistently
• Kneeling – Rarely
• Lifting