Financial Clearance Verification Specialist

$52,000 - $62,400/Yr

New York Bariatric Group - Roslyn Heights, NY

Full-time - Entry Level

Roslyn Heights, NY

Ambulatory Health Care Services

About the position

The Financial Clearance Associate (FCA) plays a crucial role in ensuring accurate and timely insurance clearance functions for a bariatric practice. This position is responsible for verifying insurance eligibility, obtaining pre-authorizations, and ensuring maximum hospital reimbursement while providing exceptional customer service to patients and stakeholders. The FCA works under the direction of the RCM Director and other supervisors, contributing to the overall success of the practice and the health outcomes of patients.

Responsibilities

• Verify insurance eligibility and determine patients' insurance coverage and authorization requirements.
• Obtain and document pre-authorizations and pre-certifications for services.
• Verify coverage levels and utilize estimation tools to calculate patients' financial responsibilities.
• Work efficiently from the system's Worklist/workflow as assigned.
• Collect pre-service payments and communicate out-of-pocket amounts to patients.
• Provide exceptional customer service to both internal and external stakeholders.
• Perform medical necessity reviews to ensure diagnoses are covered under insurance policies.
• Calculate and communicate patients' estimated out-of-pocket costs for scheduled services.
• Ensure timely and accurate documentation of all insurance clearance activities and outcomes.
• Follow up with providers' offices, scheduling departments, and insurance companies to secure authorizations.

Requirements

• High school diploma and some college preferred.
• 1-2 years of billing and/or registration experience in a healthcare organization preferred.
• 1 year related experience in a high traffic, confidential environment.
• Strong knowledge of front-end hospital, medical office, patient access, revenue cycle, and/or practice operations.
• Knowledge of medical and insurance terminology and benefit verification tools.
• Ability to perform with accuracy and attention to detail under deadlines.
• Excellent communication skills with a variety of personnel including patients and staff.
• Experience with computer hardware and software, including registration and billing systems.

Nice-to-haves

• Experience in a fast-paced healthcare environment.
• Demonstrated ability to handle confidential and sensitive matters.
• Customer-focused with a service excellence mindset.

Benefits

• Medical, Dental & Vision Insurance
• 401k & 4% Match
• Employer Paid Life and AD&D insurance
• Paid Time Off and Sick Time
• 7 Holidays
• Career Growth & Development