Financial Clearance Specialist, Pulmonology

3 weeks ago

Glen Burnie, United States University of Maryland Medical System Full time
Job DescriptionJob DescriptionCompany Description

Experience the highest level of appreciation at UM Baltimore Washington Medical Center — named Top Workplace in the Baltimore area by The Baltimore Sun two years in a row (2019 & 2020); Top Workplace in the USA for 2021  As part of the acclaimed University of Maryland Medical System, our facility is one of three ANCC Pathway to Excellence® designated hospitals in Maryland. UM BWMC features one of the state’s busiest emergency departments, as well as a team of experts who care for our community and one another.  The University of Maryland Baltimore Washington Medical Center (UMBWMC) provides the highest quality health care services to the communities we serve. Our medical center is home to leading-edge technology, nationally recognized quality, personalized service and outstanding people. We have 285 licensed beds and we’re home to 3,200 employees and over 800 physicians. Our expert physicians and experienced, compassionate staff are connected to medical practices in the local community as well as at University of Maryland Medical Center in downtown Baltimore. For patients, this means access to high-quality care and research discoveries aimed at improving Maryland’s health.  Our physicians and nursing staff specialize in emergency, acute, medical-surgical and critical care. In addition, our medical center is home to many Centers of Excellence, offering expert outpatient health care.

Job Description

Shift Schedule: Monday - Friday 8:00AM - 4:30PM

Location: Baltimore Washington Medical Center

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.
  2. Initiates and tracks referrals, insurance verification and authorizations for all encounters.
  3. Utilizes third party payer websites, real-time eligibility tools, and telephone to retrieve coverage eligibility, authorization requirements and benefit information, including copays and deductibles.
  4. Works directly with physician’s office staff to obtain clinical data needed to acquire authorization from carrier.
  5. Inputs information online or calls carrier to submit request for authorization; provides clinical back up for test and documents approval or pending status.
  6. Identifies issues and problems with referral/insurance verification processes; analyzes current processes and recommends solutions and improvements.
  7. Reviews and follows up on pending authorization requests.
  8. Coordinates and schedules services with providers and clinics.
  9. Researches delays in service and discrepancies of orders.
  10. Assists management with denial issues by providing supporting data.
  11. Pre-registers patients to obtain demographic and insurance information for registration, insurance verification, authorization, referrals and bill processing.
  12. Develops and maintains a working rapport with inter-departmental personnel including ancillary departments, physician offices, and financial services.
  13. Assists Medicare patients with the Lifetime Reserve process where applicable.
  14. Reviews previous day admissions to ensure payer notification upon observation or admission.
  15. Must be willing to travel between facilities as needed (applies to specific UMMS Facilities).
  16. Performs other duties as assigned.
Qualifications

Education and Experience

  1. High School Diploma or equivalent is required.
  2. Minimum 2 years of experience in healthcare revenue cycle, medical office, hospital, patient access or related experience.
  3. Experience in healthcare registration, scheduling, insurance referral and authorization processes preferred.

Knowledge, Skills and Abilities

  1. Knowledge of medical and insurance terminology.
  2. Knowledge of medical insurance plans, especially manage care plans.
  3. Ability to understand, interpret, evaluate, and resolve basic customer service issues.
  4. Excellent verbal communication, telephone etiquette, interviewing, and interpersonal skills to interact with peers, superiors, patients, and members of the healthcare team and external agencies.
  5. Intermediate analytical skills to resolve problems and provide patient and referring physicians with information and assistance with financial clearance issues.
  6. Basic working knowledge of UB04 and Explanation of Benefits (EOB).
  7. Some knowledge of medical terminology and CPT/ICD-10 coding.
  8. Demonstrate dependability, critical thinking, and creativity and problem-solving abilities.
  9. Knowledge of registration and admitting services, general hospital administrative practices, operational principles, The Joint Commission, federal, state, and legal statutes preferred.
  10. Knowledge of the Patient Access and hospital billing operations of Epic preferred.


Additional Information

All your information will be kept confidential according to EEO guidelines.

  • Financial Clearance Specialist, Pulmonology

    2 weeks ago

    Glen Burnie, United States The University of Maryland Medical System Full time

    Financial Clearance Specialist, Pulmonology Full-time Shift: Day Location: Baltimore Washington Medical Position Type: Non-Exempt Experience the highest level of appreciation at UM Baltimore Washington Medical Center — named Top Workplace in the Baltimore area by The Baltimore Sun two years in a row (2019 & 2020); Top Workplace in the USA for 2021! As part...

  • Financial Clearance Specialist Pulmonology

    2 weeks ago

    Glen Burnie, United States University of Maryland Medical System Full time

    Job Description Shift Schedule: Monday - Friday 8:00AM - 4:30PM Location: Baltimore Washington Medical Center ** 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...

  • Financial Clearance Specialist

    2 weeks ago

    Glen Burnie, United States University of Maryland Medical System Full time

    **Company Description** Experience the highest level of appreciation at UM Baltimore Washington Medical Center — named Top Workplace in the Baltimore area by The Baltimore Sun two years in a row (2019 & 2020); Top Workplace in the USA for 2021! As part of the acclaimed University of Maryland Medical System, our facility is one of three ANCC Pathway to...

  • Financial Clearance Specialist Full Time Days

    2 weeks ago

    Glen Burnie, United States University of Maryland Medical System Full time

    Job 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...

  • Provider Enrollment Specialist

    1 week ago

    Glen Burnie, United States Elevate Patient Financial Solution Full time

    Elevate Patient Financial Solutions has an exciting career opportunity available as an Enrollment Specialist. This position will be located in-office in Glen Burnie, MD. The Full Time schedule for this role will be Monday-Friday; 8am-5pm. JOB SUMMARY The primary focus of this role is to complete Medicaid and other government healthcare enrollments. The...

  • Provider Enrollment Specialist

    13 hours ago

    Glen Burnie, United States Elevate Patient Financial Solution Full time

    Elevate Patient Financial Solutions has an exciting career opportunity available as an Enrollment Specialist. This position will be located in-office in Glen Burnie, MD. The Full Time schedule for this role will be Monday-Friday; 8am-5pm. JOB SUMMARY The primary focus of this role is to complete Medicaid and other government healthcare enrollments. The...

  • Medical Billing Representative

    23 hours ago

    Glen Burnie, United States Elevate Patient Financial Solution Full time

    Elevate Patient Financial Solutions has an excellent career opportunity available as a OOS Medicaid Claims Specialist. This position is an office-based role working in Glen Burnie, MD. The schedule for this Full Time role is Monday-Friday; 8am-5pm. SUMMARY Elevate provides revenue cycle solutions to hospitals and physicians throughout the United States....

  • Medical Billing Representative

    1 week ago

    Glen Burnie, United States Elevate Patient Financial Solution Full time

    Elevate Patient Financial Solutions has an excellent career opportunity available as a OOS Medicaid Claims Specialist. This position is an office-based role working in Glen Burnie, MD. The schedule for this Full Time role is Monday-Friday; 8am-5pm. SUMMARY Elevate provides revenue cycle solutions to hospitals and physicians throughout the United States....

  • Housing Specialist

    1 week ago

    Glen Burnie, United States Housing Commission of Anne Arundel County Full time

    Job DescriptionJob DescriptionPurpose of Position: Under supervision of the Housing Services Manager, the Senior Housing Specialist acts as interim supervisor in the absence of the Housing Services Manager and performs a variety of duties in providing assistance to low to moderate-income families in securing affordable housing within HUD regulations and...

  • Housing Specialist

    6 hours ago

    Glen Burnie, United States Housing Commission of Anne Arundel County Full time

    Job DescriptionJob DescriptionPurpose of Position: Under supervision of the Housing Services Manager, the Senior Housing Specialist acts as interim supervisor in the absence of the Housing Services Manager and performs a variety of duties in providing assistance to low to moderate-income families in securing affordable housing within HUD regulations and...

  • Transportation Security Specialist

    1 week ago

    Glen Burnie, United States Transportation Security Administration Full time

    Transportation Security Administration Transportation Security Specialist (Explosives) Glen Burnie , Maryland Apply Now Summary Securing Travel, Protecting People - At the Transportation Security Administration, you will serve in a high-stakes environment to safeguard the American way of life. In cities across the country, you would secure airports,...

  • Housing Specialist

    1 week ago

    Glen Burnie, United States Housing Commission of Anne Arundel County Full time

    Job DescriptionJob DescriptionSummary: Under supervision of the Director of Housing Services, the Housing Specialist performs a variety of duties in providing assistance to low to moderate-income families in securing affordable housing within HUD regulations and guidelines.Essential Duties and ResponsibilitiesThe following duties are normal for this...

  • Housing Specialist

    20 hours ago

    Glen Burnie, United States Housing Commission of Anne Arundel County Full time

    Job DescriptionJob DescriptionSummary: Under supervision of the Director of Housing Services, the Housing Specialist performs a variety of duties in providing assistance to low to moderate-income families in securing affordable housing within HUD regulations and guidelines.Essential Duties and ResponsibilitiesThe following duties are normal for this...

  • ACH & Wire Specialist

    1 day ago

    Glen Falls, United States Arrow Financial Corporation Full time

    The Arrow Financial Corporation Family of Companies is seeking dynamic, authentic individuals to join our amazing team! Currently, we are looking for an experienced professional to join Deposit Services team as: ACH & Wire Specialist This opportunity may be perfect for you if you have experience in: > Ability to prioritize to meet deadlines >...

  • Transportation Security Specialist

    1 week ago

    Glen Burnie, United States Transportation Security Administration Full time

    Summary Securing Travel, Protecting People - At the Transportation Security Administration, you will serve in a high-stakes environment to safeguard the American way of life. In cities across the country, you would secure airports, seaports, railroads, highways, and/or public transit systems, thus protecting America's transportation infrastructure and...

  • Facility Admissions Coordinator, Emergency

    2 weeks ago

    Glen Burnie, United States University of Maryland Medical System Full time

    **Company Description** Experience the highest level of appreciation at UM Baltimore Washington Medical Center — named Top Workplace in the Baltimore area by The Baltimore Sun two years in a row (2019 & 2020); Top Workplace in the USA for 2021! As part of the acclaimed University of Maryland Medical System, our facility is one of three ANCC Pathway to...

  • Project Accountant

    3 weeks ago

    Glen Burnie, United States Vision Technologies Full time

    Overview: We are currently seeking a Project Accountant that will be a critical member of a U.S.-based global systems integrator providing technology solutions and services for commercial and government clients. This is a full-time permanent role supporting our corporate HQs in Glen Burnie, MD. The Project accountant is a financial specialist providing...

  • Facility Admissions Coordinator, Emergency Department, Nights

    2 weeks ago

    Glen Burnie, United States University of Maryland Medical System Full time

    Job Description SHIFT: Full-Time - 11p-7:30a Varied Days to include every other weekend. General Summary Under general supervision, performs scheduling, registration, pre-admission processing, wayfinding, and other administrative duties, while adhering to the department specific standards for data entry and patient selection. The additional duties...

  • Bankruptcy Specialist

    2 weeks ago

    Glen Allen, United States Randstad North America, Inc. Full time

    Are you interested in advancing your career with one of the oldest and largest Financial Institutions in the United States? Our client is a Fortune 500 Financial Services Company and they are hiring a Bankruptcy Specialist to join their team in Glen Specialist, Healthcare, Staffing

  • Facility Admissions Coordinator, Emergency Room

    1 month ago

    Glen Burnie, United States University of Maryland Medical System Full time

    Job DescriptionJob DescriptionCompany DescriptionExperience the highest level of appreciation at UM Baltimore Washington Medical Center — named Top Workplace in the Baltimore area by The Baltimore Sun two years in a row (2019 & 2020); Top Workplace in the USA for 2021!  As part of the acclaimed University of Maryland Medical System, our facility is one of...