Specialist II, Financial Clearance, Pt. Access – St. Peter's Hospital Remote

Job Title

Specialist II, Financial Clearance, Pt. Access – St. Peter's Hospital – Full-Time Days

Full time

Day Shift

Specialist II, Financial Clearance, Pt. Access – St. Peter's Hospital – Full-Time Days

Purpose

Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization's strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge.

Essential Functions

Our Trinity Health Culture:
Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Work Focus:
Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience. Responsible for distribution of analytical reports. Process Focus:
Utilizes multiple system applications to perform analysis, create reports & develop educational materials. Incorporates basic knowledge of Trinity Health policies, practices & processes to ensure quality, confidentiality & safety are prioritized. Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge. Data Management & Analysis:
Research & compiles information to support ad-hoc operational projects & initiatives. Synthesizes & analyzes data & provides detailed summaries including graphical data presentations illustrating trends & recommending practical options or solutions while considering the impact on business strategy & supporting leadership decision making. Leverages program & operational data & measurements to define & demonstrate progress, ROI & impacts. Maintains a Working Knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices.

Functional Role (not inclusive of titles or advancement career progression)

Specialist II

Experienced in processing financial clearance for complex services including surgical services, observation, and in-house cases.

Minimum of five (5) years of financial clearance / authorization experience in an acute care setting

Experienced in complex facility based ancillary testing across multiple facilities/states.

Responsible for complex, high-dollar services including surgical, observation and in-house services working in multiple areas of verification including outpatient verification, elective short procedure / inpatient verification, & urgent admission verification or scheduling.

Minimum Qualifications

High School Diploma or equivalent.

Two (2) to Five (5) years experience in area of expertise such as scheduling, financial clearance, or patient access.

National certification in HFMA CRCR or NAHAM CHAA required within one (1) year of hire.

Must be proficient in the use of Patient Registration/Patient Accounting systems and related software systems.

Additional Qualifications (nice to have)

Associates Degree, preferred.

Comprehensive knowledge of scheduling with mastery in at least three (3) or more modalities and insurance verification processes with three (3) years scheduling experience in an acute care setting

Experience in complex facility based ancillary testing across multiple facilities/states

Strong knowledge of third-party and government payer billing and reimbursement guidelines as well as department performance standards and policies and procedures.

Physical & Mental Requirements & Working Conditions

Direct Healthcare Services / Indirect Healthcare / Support Services:
Exposure to conditions which may be considered unpleasant to sight, touch, sound & / or smell. Occasional Exposure to fumes, odors, dusts, mists & gases, biohazards / hazards (mechanical, electrical, burns,…