Financial Clearance Specialist, PRN

3 weeks ago

Towson, United States University of Maryland Medical System Full time
Job DescriptionJob DescriptionJob Description

General Summary:

 

Under general supervision, responsible for processing the patient, insurance and financial clearance aspects for both scheduled and non-scheduled appointments, including, validation of insurance and benefits, routine and complex pre-certification, prior authorizations, and scheduling/pre-registration.  Responsible for triaging routine financial clearance work.

 

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification.  These are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

 

  1. Processes administrative and financial components of financial clearance including, validation of insurance/benefits, medical necessity validation, routine and complex pre-certification, prior-authorization, scheduling/pre-registration, patient benefit and cost estimates, as well as pre-collection of out of pocket cost share and financial assistance referrals.

 

  1. Initiates and tracks referrals, insurance verification and authorizations for all encounters.

 

  1. Utilizes third party payer websites, real-time eligibility tools, and telephone to retrieve coverage eligibility, authorization requirements and benefit information, including copays and deductibles.

 

  1. Works directly with physician’s office staff to obtain clinical data needed to acquire authorization from carrier.

 

  1. Inputs information online or calls carrier to submit request for authorization; provides clinical back up for test and documents approval or pending status.

 

  1. Identifies issues and problems with referral/insurance verification processes; analyzes current processes and recommends solutions and improvements.

 

  1. Reviews and follows up on pending authorization requests.

 

  1. Coordinates and schedules services with providers and clinics.

 

  1. Researches delays in service and discrepancies of orders.

 

  1. Assists management with denial issues by providing supporting data.

 

  1. Pre-registers patients to obtain demographic and insurance information for registration, insurance verification, authorization, referrals and bill processing.

 

  1. Develops and maintains a working rapport with inter-departmental personnel including ancillary departments, physician offices, and financial services.

 

  1. Assists Medicare patients with the Lifetime Reserve process where applicable.

 

  1. Reviews previous day admissions to ensure payer notification upon observation or admission.

 

  1. Must be willing to travel between facilities as needed (applies to specific UMMS Facilities).

 

  1. Performs other duties as assigned.

 

Qualifications

Education and Experience

 

  1. High School Diploma or equivalent is required.

 

  1. Minimum two years of experience in healthcare revenue cycle, medical office, hospital, patient access or related experience.

 

  1. Experience in healthcare registration, scheduling, insurance referral and authorization processes preferred.


Additional Information

Knowledge, Skills and Abilities

  1. Knowledge of medical and insurance terminology.

 

  1. Knowledge of medical insurance plans, especially manage care plans.

 

  1. Ability to understand, interpret, evaluate, and resolve basic customer service issues.

 

  1. Excellent verbal communication, telephone etiquette, interviewing, and interpersonal skills to interact with peers, superiors, patients, and members of the healthcare team and external agencies.

 

  1. Intermediate analytical skills to resolve problems and provide patient and referring physicians with information and assistance with financial clearance issues.

 

  1. Basic working knowledge of UB04 and Explanation of Benefits (EOB).

 

  1. Some knowledge of medical terminology and CPT/ICD-10 coding.

 

  1. Demonstrate dependability, critical thinking, and creativity and problem-solving abilities.

 

  1. Knowledge of registration and admitting services, general hospital administrative practices, operational principles, The Joint Commission, federal, state, and legal statutes preferred.

 

  1. Knowledge of the Patient Access and hospital billing operations of Epic preferred.

 

  • Financial Clearance Specialist, PRN

    2 weeks ago

    Towson, United States The University of Maryland Medical System Full time

    Under general supervision, responsible for processing the patient, insurance and financial clearance aspects for both scheduled and non-scheduled appointments, including, validation of insurance and benefits, routine and complex pre-certification, prior authorizations, and scheduling/pre-registration. Responsible for triaging routine financial clearance...

  • Financial Clearance Specialist, PRN

    2 weeks ago

    Towson, United States The University of Maryland Medical System Full time

    Under general supervision, responsible for processing the patient, insurance and financial clearance aspects for both scheduled and non-scheduled appointments, including, validation of insurance and benefits, routine and complex pre-certification, prior authorizations, and scheduling/pre-registration. Responsible for triaging routine financial clearance...

  • Financial Clearance Specialist, PRN

    6 days ago

    Towson, United States University of Maryland Medical System Full time

    Job DescriptionJob DescriptionJob DescriptionGeneral Summary: Under general supervision, responsible for processing the patient, insurance and financial clearance aspects for both scheduled and non-scheduled appointments, including, validation of insurance and benefits, routine and complex pre-certification, prior authorizations, and...

  • Financial Clearance Specialist, PRN

    2 weeks ago

    Towson, United States University of Maryland Medical System Full time

    Job DescriptionJob DescriptionJob DescriptionGeneral Summary: Under general supervision, responsible for processing the patient, insurance and financial clearance aspects for both scheduled and non-scheduled appointments, including, validation of insurance and benefits, routine and complex pre-certification, prior authorizations, and...

  • Financial Clearance Specialist, PRN

    2 days ago

    Towson, United States University of Maryland Medical System Full time

    Job DescriptionJob DescriptionJob DescriptionGeneral Summary: Under general supervision, responsible for processing the patient, insurance and financial clearance aspects for both scheduled and non-scheduled appointments, including, validation of insurance and benefits, routine and complex pre-certification, prior authorizations, and...

  • Accounts Payable Specialist

    1 week ago

    Towson, United States Creative Financial Staffing Full time

    Company and Overview: Our repeat client is a leader in the healthcare industry! They pride themselves on being a learning organization and leading by their core values. They have a great culture and are known for implementing new processes to help increase workflow and productivity. They are currently looking to hire a second Accounts Payable Specialist to...

  • Child Life Specialist

    2 weeks ago

    Towson, United States Greater Baltimore Medical Center Full time

    Under limited supervision, the Certified Child Life Specialist (CCLS) provides psychosocial and emotional support for pediatric & adolescent patients and their families receiving care at GBMC. The CCLS utilizes a family-centered care approach to assists patients and families in effectively coping with the stress and anxiety of the hospital experience as well...

  • Child Life Specialist

    2 days ago

    Towson, United States Greater Baltimore Medical Center Full time

    Under limited supervision, the Certified Child Life Specialist (CCLS) provides psychosocial and emotional support for pediatric & adolescent patients and their families receiving care at GBMC. The CCLS utilizes a family-centered care approach to assists patients and families in effectively coping with the stress and anxiety of the hospital experience as well...

  • Facility Admissions Coordinator, PRN

    2 days ago

    Towson, United States University of Maryland Medical System Full time

    Job DescriptionJob DescriptionCompany DescriptionWhen you come to the University of Maryland St. Joseph Medical Center, you’re coming to more than simply a beautiful 37-acre, 218-bed suburban Baltimore, Maryland campus. You’re embarking on a professional journey that encourages opportunities, values a team atmosphere, and makes convenience and...

  • Client Relationship Specialist- Towson, MD

    2 days ago

    Towson, United States Charles Schwab Corporation Full time

    Your Opportunity At Schwab, you're empowered to make an impact on your career. Here, innovative thought meets creative problem solving, helping us "challenge the status quo" and transform the finance industry together. As a Client Relationship Specialist (CRS), you have the opportunity to bring your passion for customer service to a role and a firm that...

  • Mental Health Specialist

    2 weeks ago

    Towson, United States Sheppard Pratt Full time

    A day hospital is a psychiatric program you attend during weekdays, returning to the comfort of home in the evenings and on weekends. It is a less intensive level of care than inpatient but provides more support than an outpatient setting. Many people we serve find that day hospital treatment is a helpful step down from inpatient care before returning to...

  • Mental Health Specialist

    2 days ago

    Towson, United States Sheppard Pratt Full time

    A day hospital is a psychiatric program you attend during weekdays, returning to the comfort of home in the evenings and on weekends. It is a less intensive level of care than inpatient but provides more support than an outpatient setting. Many people we serve find that day hospital treatment is a helpful step down from inpatient care before returning to...

  • Mental Health Specialist

    2 days ago

    Towson, United States Sheppard Pratt Full time

    A day hospital is a psychiatric program you attend during weekdays, returning to the comfort of home in the evenings and on weekends. It is a less intensive level of care than inpatient but provides more support than an outpatient setting. Many people we serve find that day hospital treatment is a helpful step down from inpatient care before returning to...

  • Cashier - PRN

    4 days ago

    Towson, United States Greater Baltimore Medical Center Healthcare Full time

    Under general supervision but according to established policies and procedures, operates a cash receipt system to record, collect, and distribute cash transactions. Performs a variety of bookkeeping duties and closes out cash register at end of scheduled shift.Education: None Experience: Six months' experience cashiering in order to be familiar with cash...

  • Cashier - PRN

    2 days ago

    Towson, United States Greater Baltimore Medical Center Healthcare Full time

    Under general supervision but according to established policies and procedures, operates a cash receipt system to record, collect, and distribute cash transactions. Performs a variety of bookkeeping duties and closes out cash register at end of scheduled shift.Education: None Experience: Six months' experience cashiering in order to be familiar with cash...

  • Behavioral Health Associate Supervisor

    6 days ago

    Towson, United States Baltimore County Full time

    Salary: $22.43 - $34.20 Hourly Location : Towson, MD Job Type: NON-MERIT Job Number: NM.143 02-24 Department: HHS/BEHAVIORAL HEALTH Opening Date: 02/01/2024 Closing Date: Continuous Regular Schedule: 34 hours per week. A non-merit vacancy exists in the Bureau of Behavioral Health, Department of Health and Human Services. Non-Merit positions are not...

  • Behavioral Health Associate Supervisor

    3 days ago

    Towson, United States Baltimore County Full time

    Salary: $22.43 - $34.20 Hourly Location : Towson, MD Job Type: NON-MERIT Job Number: NM.143 02-24 Department: HHS/BEHAVIORAL HEALTH Opening Date: 02/01/2024 Closing Date: Continuous Regular Schedule: 34 hours per week. A non-merit vacancy exists in the Bureau of Behavioral Health, Department of Health and Human Services. Non-Merit positions are not...

  • Behavioral Health Associate

    6 days ago

    Towson, United States Baltimore County Full time

    Salary: $19.54 - $30.80 Hourly Location : Towson, MD Job Type: NON-MERIT Job Number: NM.142 12-22 Department: HEALTH Opening Date: 03/05/2024 Regular Schedule: 34 hours per week Vacancies exist in the Bureau of Behavioral Health, Department of Health and Human Services. Non-Merit positions are not classified within the Baltimore County Government...

  • Behavioral Health Associate

    2 days ago

    Towson, United States Baltimore County Full time

    Salary: $19.54 - $30.80 Hourly Location : Towson, MD Job Type: NON-MERIT Job Number: NM.142 12-22 Department: HEALTH Opening Date: 03/05/2024 Regular Schedule: 34 hours per week Vacancies exist in the Bureau of Behavioral Health, Department of Health and Human Services. Non-Merit positions are not classified within the Baltimore County Government...

  • Clinical Social Worker, PRN

    1 week ago

    Towson, United States University of Maryland Medical System Full time

    Job DescriptionJob DescriptionCompany DescriptionWhen you come to the University of Maryland St. Joseph Medical Center, you’re coming to more than simply a beautiful 37-acre, 218-bed suburban Baltimore, Maryland campus. You’re embarking on a professional journey that encourages opportunities, values a team atmosphere, and makes convenience and...