Financial Clearance Specialist Full Time Days

4 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 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:
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 Full Time Days

    3 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...

  • Financial Clearance Specialist, Pulmonology

    3 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

    3 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 Pulmonology

    3 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, Pulmonology

    4 weeks 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...

  • Provider Enrollment Specialist

    2 weeks 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

    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...

  • Medical Billing Representative

    2 weeks 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....

  • Facility Admissions Coordinator, Emergency Room

    2 months 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...

  • Integrated Circuit Design Engineer with Security Clearance

    3 weeks ago

    Glen Burnie, United States Associates Systems LLC Full time

    All Qualified Resumes Will Be Responded to in 24 Hrs or Less US Citizen willing to submit for a DOD Clearance. All work is on-site AForge offers a full suite of Benefits: 100% medical, Dental, 401k, PTO, and Holiday compensation. Required Education: Bachelor's degree in Electrical Engineering or related field with 14 years of experience in either Analog,...

  • Office Support Specialist

    1 day ago

    Glen Burnie, United States Anne Arundel County, MD Full time

    **Position Description**: This position announcement will be used to fill a full-time, permanent Office Support Specialist vacancy in the Office of Emergency Management with Anne Arundel County. This is advanced level office support work requiring special skills and knowledge in a specific program area. Personal contacts are with county managers, employees,...

  • Dermatology Specialist

    3 weeks ago

    Glen Burnie, United States ENTAA Care Full time

    Dermatology Specialist a division of ENTAA Care, a member of Johns Hopkins Regional Physicians LLC, is a group of dermatologists, otolaryngologists and allergists in a dynamic practice in Central Maryland. The dermatology division is growing rapidly and offers a full range of services including adult, pediatric, surgical and cosmetic dermatology. We are...

  • Dermatology Specialist

    2 months ago

    Glen Burnie, United States ENTAA Care Full time

    Dermatology Specialist a division of ENTAA Care, a member of Johns Hopkins Regional Physicians LLC, is a group of dermatologists, otolaryngologists and allergists in a dynamic practice in Central Maryland. The dermatology division is growing rapidly and offers a full range of services including adult, pediatric, surgical and cosmetic dermatology. We are...

  • Teacher (Full-time)

    4 weeks ago

    Glen Burnie, United States St. Paul's Lutheran Church Full time

    Organization: St. Paul’s Lutheran School City: Glen Burnie, MD 21061 Address: 308 Oak Manor Drive Category: Grade 1-3 Teacher, Self Contained Classroom Position Type: Instructor, Full-Time Education: Bachelor’s Degree Required Applicant must be able to pass a full criminal background check. Pay: $30,000.00 - $42,500.00 per year **Benefits**: -...

  • Facility Admissions Coordinator, Emergency Department, Days

    3 weeks 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...

  • Facility Admissions Coordinator, Emergency Department, Days

    1 week 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...

  • Transportation Security Specialist

    3 weeks 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,...

  • Security Officer Full Time

    1 week ago

    Glen Burnie, United States Allied Universal® Full time

    Security Officer Full Time **Overview**: Allied Universal®, North America's leading security and facility services company, provides rewarding careers that give you a sense of purpose. While working in a dynamic, diverse and inclusive workplace, you will be part of a team that fuels a culture that will reflect in our communities and customers we serve. We...

  • Security Officer Full Time

    2 weeks ago

    Glen Burnie, United States Allied Universal® Full time

    Security Officer Full Time **Overview**: Allied Universal®, North America's leading security and facility services company, provides rewarding careers that give you a sense of purpose. While working in a dynamic, diverse and inclusive workplace, you will be part of a team that fuels a culture that will reflect in our communities and customers we serve. We...