Financial Clearance Specialist - REMOTE Job Worcester Massachusetts USA,Healthcare

Overview

Are you a current UMass Memorial Health caregiver? Apply now through Workday.

Exemption Status: Non-Exempt

Hiring Range: $20.94 - $33.59

Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations.

Schedule Details: Monday through Friday

Scheduled

Hours:

8a-4:30p

Shift: 1 - Day Shift, 8 Hours (United States of America)

Hours: 40

Cost Center: 99940 - 5479 Financial Clearance PAC

Union: SHARE (State Healthcare and Research Employees)

This position may have a signing bonus available. A member of the Recruitment Team will confirm eligibility during the interview process.

Everyone Is a Caregiver. At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other.

And everyone, in their own unique way, plays an important part, every day.

Responsibilities

Responsible for assessing and verifying patient information for scheduled medical services. This includes verification of patient demographic, financial and insurance information. Collects co-pays, deductibles, coinsurances, and down payments. Provides estimates for services when appropriate. Receives and processes patient financial liability payments for current and past balances. Focus is to collect patient liabilities prior to service and to resolve any insurance and financial issues prior to services being rendered.

Reschedules appointments when appropriate under the guidance of department leader.

Front line for customer service, pre-registration and access to care for scheduled services.

Initiates contact with insurance companies to obtain eligibility, gather accurate patient billing information, and perform collections with outstanding accounts receivable.

Accurately estimates the patient financial liability (copayments, deductibles, coinsurances, deposits, etc.) via obtaining accurate demographic and financial information; answers patient inquiries regarding their liability and explains variables involved.

Receives and processes patient payments.

Ensures pre-certification authorization and/or referral is in place prior to service being rendered.

Appropriately refers patients to Financial Counselors or Business Office depending on patient need.

Reschedules appointments when requested by patient or, under advisement of department leader, when due to financial circumstances appointment requires postponement.

Enters clear, concise notes concerning financial clearance status in the system based on communications.

Demonstrates knowledge and understanding of all job-related policies and procedures and adheres to the Financial Clearance Policy in all patient cases.

Assesses gaps in patient coverage to determine patient financial exposure prior to rendering service.

Responds flexibly to changing situations to meet current needs, such as reprioritizing work as necessary.

Performs other duties as assigned, or directed, to ensure smooth operation of the department/unit.

Position Qualifications

License/Certification/Education

Required: Minimum High School Diploma or G.E.D. Business concentration preferred.

Preferred: Associate degree, or higher, preferred.

Experience/Skills

Required: Four plus (4+) years of experience within a business office setting, hospital revenue cycle preferred, physician office or collection agency; prior experience in a healthcare environment required.

Preferred: Working knowledge of personal computers and business office applications; familiarity with hospital computer systems; knowledge of third party collections and reimbursement.

Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements.

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