Our Billing Co. is seeking a Patient Financial Clearance Representative to join our team! The primary responsibilities of the Patient Financial Clearance Representative are to perform activities related to outpatient registration, insurance verification, authorization, pre-certification, financial clearance process, chart preparation and advising patients of their financial responsibility. Refer uninsured or underinsured patients to the facilitated enrollers for assistance. Additional responsibilities include interviewing patients/guarantors to obtain demographic and confidential clinical and financial information necessary to appropriately register, obtain treatment authorizations and verify insurance eligibility and corresponding benefit levels. Critical to this position is the ability to gather and record all appropriate information that supports the groundwork for the remaining or future fiscal efforts of Our Billing Company.

Essential Functions:

• Utilizing department work queues, calls, interviews and registers patients to obtain demographic, clinical and financial information. Determines the patient’s type of insurance coverage and educates the patient regarding coverage. Informs patient of all appropriate co-payments and insurance deductibles and collects them.
• Investigates, resolves and documents patient and account problems in a timely, efficient manner. Contacts physicians’ offices, insurance companies, and ancillary departments and administration as needed.
• Verify insurance eligibility, benefits, and reimbursement requirements utilizing HealtheNet, KIICS, Eclipsys Eligibility, or other tools as determined by third party payers, including verbal/telephone and written communication. Document results on the patient record.
• Refer uninsured and/or underinsured patients to the Facilitated Enrollment Team for financial screening.
• Thoroughly searches the EHR for all patients prior to scheduling and registration to determine whether the patient has already been assigned a medical record number.
• Accurately enters all demographic and financial information into the EHR, according to the standardization policy.
• Act as a patient advocate and assist in the completion of payer required forms to ensure timely eligibility and reimbursement.
• Interact and communicate with payers, customers, government regulatory agencies, supporting vendors, and health system departments in a professional manner.
• Verify and update the patient record within the system with appropriate demographic, insurance, guarantor information, and generate rebill request as appropriate. Document all inquiries and responses on the patient record.
• Maintain documentation and logs as required.
• Participates in test teams for the installation of additional software applications to improve the efficiency and/or effectiveness of the scheduling, registration, insurance verification and/or customer service processes.
• Respond to daily patient and insurance inquiries, both written and verbal while respecting patient rights as determined by HIPAA, corporate policies/procedures, team standards, payer contracts and/or Directors.
• Deliver exemplary customer service to provide a positive experience across the organization.
• Perform other duties assigned by management.

Education and Experience/Certification or License:

• Education (Minimum Needed): HS - High School Diploma or GED
• Experience (Minimum Needed): 1 year of experience in clerical, preferably in a healthcare setting
• Specialized Knowledge Needed for Performance of Job: Payer requirements, registration
• Special Skills: Data Entry, Customer Service, and Clerical skills
• Other: Act as a patient advocate and assist in the completion of payer required forms to ensue timely eligibility and reimbursement

Our Billing Co. offers a competitive benefits package.

Pay range: $17.90 - $19.00

Individual annual salaries/hourly rates will be set within job's compensation range, and will be determined by considering factors including, but not limited to market data, education, experience, qualifications, and experience, qualifications, and expertise of the individual and internal equity considerations.

This position requires constant sitting in an office environment. Employees may be asked to occasionally perform other movements or physical tasks. Workplace accommodations may be available for employees in accordance with the Americans with Disabilities Act.