Financial Clearance Specialist III - Pre Arrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

Job description

The Financial Clearance Specialist III is responsible for ensuring insurance eligibility, benefit verification, and the authorization processes are complete in the time allowed by the insurance companies to prevent denials or penalties. Documenting accurate insurance information and authorization details to optimize reimbursement from both the payer and patient. Maintain strong working knowledge of insurance plans, contract requirements, and resources to facilitate appropriate insurance verification and authorization. Must be able to run eligibility and secure full benefit coverage information (including COBRA when applicable) with insurance companies and employers, confirm all demographic information is correct, and ensure coordination of benefit (COB) and insurance plan codes are accurate. Verify insurance coverage immediately for inpatient and outpatient accounts that are same day and next day add-ons. Determine if pre-certification, pre-authorization or a referral is required for insurance companies and obtain if applicable. Communicate with providers and team regarding out-of-network issues, assess contracted and non-contracted payer issues, and document outcomes and next step...