Financial Clearance Specialist
1 week ago
Signature Healthcare is Southeastern Massachusetts premier local provider of quality, personalized medical services. We are comprised of the award-winning not-for-profit Signature Healthcare Brockton Hospital; Signature Medical Group (SMG), a multi-specialty physician group of more than 150 physicians practicing in 18 ambulatory locations. We believe our distinctive Signature Healthcare team approach is the way healthcare should be: medical professionals across many locations communicating and collaborating, taking advantage of technologies and resources to make a difference in the lives and health of our patients.
Position Summary:
Financial Clearance Specialist ensures all necessary information is proactively obtained and verified for proper financial reimbursement of services provided while maintaining a positive patient experience.
Location: 750 W. Center Street, West Bridgewater, MA
Department: Financial Clearance Specialist
This is a full-time 40 hour/ week position
Responsibilities:
+ Accesses work queues and reports and reviews patient accounts to determine financial clearance status of specific patient services.
+ Takes action on those services without financial clearance.
+ Ensures demographic and patient contact information is complete and verified with the patient or patient representative.
+ Verifies the guarantor type and information and ensures it is assigned to the account correctly. This includes personal/family relations, workers compensation insurance, third parties, behavioral health or others as required.
+ Ensures all possible coverages are created and verified, through electronic or manual methods, and all discrepancies are resolved.
+ Validates that coverages are assigned to appropriate visit.
+ Collects and validates order-related information including office visit, radiology and surgical orders.
+ Follows up with ordering provider to verify CPT codes.
+ Verifies Primary Care Physician (PCP) information and ensures appropriate PCP referrals are in place for the provider and service by checking electronic systems and calling PCP offices.
+ Enters and links referrals and/or authorizations in system.
+ Processes referrals when necessary, assuring proper tracking and redirection when appropriate.
+ Using system activities and functions, identifies non-covered services and prepares proper Advance Notice Beneficiary (ABN) or waiver for registration team. Documents account for registrar action.
+ Analyzes clinical documentation in support of ordered procedure(s) and submits precertification requests through various insurance fax lines, phone systems and web portals.
+ Follows up on pending accounts and involves ordering provider offices as needed to obtain approvals.
+ Escalates challenging accounts to provider representative to ensure accounts are approved at least two weeks prior to patient appointment/surgery.
+ Verifies covered benefits, including remaining hospital days, carve out coverages and benefit limits of visit and/or timeframe.
+ Contacts patients, providers and insurance companies to validate data, collect missing information and resolve information discrepancies.
+ Understands clinical guidelines for payers requiring authorization to better build cases for authorization requests and provide feedback to clinical departments on required notes.
+ Communicates with patients and discusses their financial clearance status when necessary.
Education/Experience/Licenses/Technical/Other:
+ Education: High school graduate or equivalent
+ Experience:At least two years prior experience in a health care setting requiring knowledge of insurance coverage, reimbursement, and/or medical terminology and coding. Experience providing customer service, while processing and verifying electronic demographic, financial or other business-related information and data.
+ Certification/Licensure:
+ Software/Hardware: Meditech experience preferred.
+ Other:
-
Financial Clearance Specialist
6 days ago
West Bridgewater, United States Brockton Hospital Full timeSignature Healthcare is Southeastern Massachusetts premier local provider of quality, personalized medical services. We are comprised of the award-winning not-for-profit Signature Healthcare Brockton Hospital; Signature Medical Group (SMG), a multi-specialty physician group of more than 150 physicians practicing in 18 ambulatory locations. We believe our...
-
Senior Financial Services Coordinator
6 days ago
West Bridgewater, Massachusetts, United States Brockton Hospital Full timeBrockton Hospital, a premier healthcare provider in Southeastern Massachusetts, is seeking a highly skilled Senior Financial Services Coordinator to join its team.Estimated Annual Salary: $62,000 - $85,000About the Role:The Senior Financial Services Coordinator will play a critical role in ensuring the smooth financial reimbursement of services provided by...
-
Senior Financial Planning Specialist
7 days ago
West Valley City, Utah, United States OneMain Financial Full timeRole OverviewWe are seeking a highly skilled Senior Financial Planning Specialist to join our team at OneMain Financial. As a key member of our finance team, you will be responsible for supporting the financial planning and analysis functions.Key Responsibilities:Support the development of financial models and forecasts to inform business decisionsAnalyze...
-
Financial Accountant Specialist
4 days ago
West Simsbury, Connecticut, United States Creative Financial Staffing Full timeAbout the RoleWe are seeking a detail-oriented Financial Accountant Specialist to join our team in Simsbury. As an Accounts Receivable professional, you will be responsible for managing customer accounts, processing payments, and maintaining accurate financial records.
-
Financial Operations Specialist
3 days ago
West Springfield, Massachusetts, United States Creative Financial Staffing Full timeOverview of the Role: The Financial Operations Specialist - Construction Division will oversee all accounting and financial operations functions including billing, accounts payable, cost accounting and general accounting. Responsibilities: Preparation of financial statements and financial reportingOversee and develop staffFinance process automationWork...
-
west haven, United States Creative Financial Staffing Full timeAccounts Receivable Specialist Why Work Here? Growing company Join a vibrant and supportive team that values your contributions and encourages professional growth! Competitive compensation Work life balance Responsibilities of the Accounts Receivable Specialist The Accounts Receivable Specialist will proactively manage accounts receivable, identifying and...
-
Highly Skilled Access Control Specialist
7 days ago
Key West, Florida, United States Top Secret Clearance Jobs Full timeAbout Top Secret Clearance JobsWe are a leading provider of top-secret clearance jobs, dedicated to delivering exceptional services to our clients. Our team of experts is committed to ensuring the highest level of security and confidentiality in all our projects.Job OverviewWe are currently seeking an experienced Physical Security Systems Technician to join...
-
Financial Analyst III
4 days ago
West Palm Beach, United States Amentum Full timeAmentum is seeking a Finance Analyst III in West Palm Beach, Florida to work both independently and as part of our Team to accomplish a range of functions in support of the Atlantic Undersea Test & Evaluation Center (AUTEC) program. The Finance Analyst will calculate, monitor, and audit direct costs focusing on budgets and Estimate at Complete (EAC) –...
-
Project Control Specialist
1 month ago
West Palm Beach, United States Amentum Full timeAmentum is seeking a Project Control Specialist in West Palm Beach, Florida to work as part of a close-knit team, as well as independently, to accomplish a range of functions as you support AUTEC. The selected candidate will create and maintain time-phased project budgets using MS Excel, Power BI Cognos and Costpoint. Provide budget and schedule coordination...
-
Financial Operations Specialist
7 days ago
West Palm Beach, Florida, United States Creative Financial Staffing Full timeCompany OverviewCreative Financial Staffing is a privately owned company with 30 years of experience in the financial industry.
-
Debt Resolution Specialist
1 week ago
West Valley City, Utah, United States OneMain Financial Full timeAbout OneMain Financial">At OneMain Financial, we believe in responsible access to credit for hardworking Americans. For over a century, we've helped people achieve their financial goals through our suite of personal loans, credit cards, and other products.">A Competitive Salary: $60,000 - $80,000 per year">As a Debt Resolution Specialist with OneMain...
-
Billing Specialist
1 month ago
Bridgewater, United States Summit Drilling Full timeJob DescriptionJob DescriptionWork Hours: Hybrid, 4 days in-office and 1 day remote. Standard office hours with reasonable flexibility on start and end time. Full time, W-2 positionLocation: Bridgewater, NJCompensation: $60,000-70,000 salary based on experience with bonus potential.Company Benefits:Work-Health-Life Balance BenefitsMedical Insurance options...
-
Account Recovery Specialist
3 days ago
West Valley City, Utah, United States OneMain Financial Full timeJob Description:As an Account Recovery Specialist with OneMain Financial, you will play a critical role in helping customers get back on track with their financial obligations. Your primary responsibility will be to locate and negotiate with delinquent account holders to find affordable repayment solutions.Responsibilities:Review and monitor delinquent...
-
Consumer Loan Sales Specialist
4 months ago
West Berlin, United States OneMain Financial Full timeAt OneMain, Consumer Loan Sales Specialists empower customers - listening to their needs and providing access to friendly, fast, and affordable financing for life's expenses. Consumer Loan Sales Specialist will learn the lending and servicing business at OneMain allowing them to grow their career. In the RoleDeliver results related to individual and branch...
-
Financial Operations Specialist
7 days ago
West Palm Beach, Florida, United States Randstad North America, Inc. Full timeJob OverviewRandstad North America, Inc. is a leading provider of staffing and recruitment services, seeking an experienced Financial Operations Specialist. As a key member of our team, you will be responsible for managing all aspects of job-related accounting activities.About the RoleThe Financial Operations Specialist will work closely with the Project...
-
Financial Systems Specialist
6 days ago
West Lafayette, Indiana, United States Purdue Research Foundation Full timeWe are seeking a highly skilled Financial Systems Specialist to join our team at the Purdue Research Foundation.Job Description:The successful candidate will be responsible for providing technical support and training to staff on financial software applications, including OneSolution, CCH, and Yardi Voyager. This role requires excellent problem-solving...
-
Financial Operations Specialist
7 days ago
West Monroe, Louisiana, United States Advantage Resourcing Full timeAre you a meticulous and detail-oriented professional with a strong background in financial operations? Advantage Resourcing is hiring an experienced Financial Operations Specialist to join our client's collaborative team.About the RoleWe are seeking a highly organized individual to maintain accurate financial records, manage accounts payable and receivable,...
-
Protection Specialist
3 days ago
West Palm Beach, Florida, United States Allied Universal® Full timeCompany Overview">Allied Universal is a leading security and facility services company dedicated to providing rewarding careers that give you a sense of purpose.">Salary">$23.50 per hour, with opportunities for advancement and career growth.">Job Description">We are seeking a skilled Protection Specialist to join our team. As an Armed Cleared Security...
-
Accounts Receivable Specialist CT
6 days ago
west haven, United States Creative Financial Staffing Full timeAccounts Receivable Specialist Why Work Here? Growing company Join a vibrant and supportive team that values your contributions and encourages professional growth! Competitive compensation Work life balance Responsibilities of the Accounts Receivable Specialist The Accounts Receivable Specialist will proactively manage accounts receivable, identifying and...
-
Financial Analysis Specialist
3 weeks ago
West Palm Beach, Florida, United States Legal Graphicworks Full timeJob DescriptionWe are seeking a highly skilled Financial Analysis Specialist to join our team at Legal Graphicworks.This role is designed to add depth and strength to our accounting team, requiring an analytical self-starter with a knowledge of and experience in segregation of duties and workflow documentation, as well as the ability to follow processes and...