Financial Clearance Specialist

Kootenai Health - Coeur d'Alene, ID

Full-time

Hybrid - Coeur d'Alene, ID

Hospitals

About the position

The Financial Clearance Specialist is responsible for obtaining and reviewing clinical procedure orders, ensuring that procedures are scheduled appropriately. This role involves direct interaction with patients, provider clinics, insurance companies, and government agencies to gather relevant information for upcoming testing or procedure visits. The specialist also communicates financial responsibilities to patients and their families, handling all administrative and financial components of financial clearance.

Responsibilities

• Collects demographic, insurance, and financial information from incoming patients prior to delivery of services
• Identifies and verifies active payer sources for patients
• May perform scheduling functionality in collaboration with appropriate service line resource utilization
• May assist in point of service admissions processes
• Obtains any pre-authorizations / pre-certifies services to secure payer payment obligation
• Reviews claims or records to ensure accurate completion or coding in an effort to reduce reimbursement denials
• Calculates, communicates, and attempts to collect patient financial liability as assigned by patient's insurance policy
• Educates patients on insurance policy limitations, self-pay obligation, payment alternatives, and assists patient in navigating the financial assistance programs offered through the Business Office
• Communicates with patients, physicians, payers, families and co-workers in person and on telephone
• Performs other related duties as assigned
• Familiar with standard concepts, practices, and procedures within the field
• Maintains regular and predictable attendance as an essential job function
• Competent to meet age specific needs of the unit assigned

Requirements

• High school diploma preferred
• Minimum of 1 to 3 years' experience in Patient Registrar, Medical Billing Office or Insurance required
• Knowledge of ICD10, CPT4, and HCPCS codes; and Medical Terminology required

Benefits

• 100% employer-paid health insurance premiums for full-time employees
• Part-time employees pay only a small portion a month for medical, dental, and vision coverage
• Benefits start 1st of the month following 30 days of employment
• Tuition assistance program available after 90 days
• Defined contribution 457 retirement plan with employer matching
• Competitive salaries with night, weekend and PRN shift differentials
• Award-winning wellness program
• Employee discounts at The Wellness Bar, PEAK Fitness, and various cell phone carriers
• Robust employee bonus program