Financial Clearing Specialist

6 days ago

Sydney, New South Wales, Australia beBeeAuthorization Full time $80,000 - $95,000

**Patient Financial Clearing Specialist Role Summary:**

Ensures patients are appropriately financially cleared for all appointments.

This role involves performing eligibility verification, obtaining pre-certifications and/or authorizations, clearing registration errors, editing pre-bill, and performing other duties as required.

Maintains a close working relationship with clinical partners to ensure continual open communication between clinical, ancillary, and patient access departments.

Job Responsibilities:
  • Proactively contacts insurance companies by phone, fax, online portal, and other resources to obtain and verify insurance eligibility and benefits.
  • Meet department standards when obtaining pre-authorizations from third-party payers in accordance with payer requirements and within established timeframes.
  • Accurately enters required authorization information in healthcare systems, including length of authorization, total number of visits, and/or units of medication.
  • Maintain close working relationships with clinical partners and physician offices to resolve issues with obtaining pre-authorizations.
  • Conducts diligent follow-up on missing or incomplete pre-authorizations with third-party payers through phone calls, emails, faxes, and payer websites, updating documentation as needed.
  • Minimizes duplication of medical records by verifying patient identity through demographic details.
  • Ensures patient accounts are assigned the appropriate payor plans.
  • Ensures all financial assessments, eligibility, and benefits are updated and thorough to support post-care financial needs.
  • Thoroughly documents all conversations with patients and insurance representatives, including payer decisions, collection attempts, and payment plan arrangements.
  • Coordinates with case management staff as necessary (e.g., when pre-authorization cannot be obtained for an inpatient stay).
  • Adheres to HIPAA regulations by verifying caller authorization levels.
  • Creates accurate estimates to maximize up-front cash collections and adds collections documentation where required.
  • Calculates patients' co-pays, deductibles, and co-insurance, providing personalized estimates based on their insurance coverage or eligibility for government programs prior to service.
Requirements:
  • One year of customer service experience
  • High School diploma or GED

Benefits:
  • Benefits from Day One
  • Paid Days Off from Day One
  • Student Loan Repayment Program
  • Career Development
  • Whole Person Wellbeing Resources
  • Mental Health Resources and Support
  • Pet Insurance*
  • Debt-free Education* (Certifications and Degrees without out-of-pocket tuition expense)

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