Financial Clearance Expert

3 weeks ago


Nashville, Tennessee, United States Vanderbilt University Medical Center Full time
Vanderbilt University Medical Center: We are a leading provider of organ transplantation in the United States, offering advanced care for end-stage organ failure in children and adults. As Tennessee's only full-service transplant center, we have been committed to providing lifesaving transplants to people from all over the world for more than six decades.

We are currently seeking a Senior Financial Clearance Specialist to join our team. This role will be responsible for performing and documenting pre-certification from insurance companies for all elective surgeries and visits, with minimal guidance. The ideal candidate will provide guidance as a financial clearance specialist at any time during the patient's transplant care. Candidates with a heavy insurance/referral/pre-appointment coordinator/prior authorization background are highly desirable.

The VUMC Pediatric Transplant Department is looking for an experienced professional to support our team in achieving our mission of advancing health and wellness through preeminent programs in patient care, education, and research.

Key Responsibilities:
+ Obtains certification from insurance companies for all elective out-patient specialty surgeries for both the surgeon and the facility.
+ Contacts insurance review agencies to request authorization.
+ Handles problematic certification cases with relevant internal groups.
+ Performs investigative and follow-up work on cases with pre-certification issues until the issue is resolved.
+ Documents certification process in the appropriate applications to facilitate accurate concurrent review, billing and reimbursement.

Technical Capabilities:
+ Insurance Regulatory Knowledge: Demonstrates knowledge of the appropriate rules and regulations for insurance policies, claims, payment and coverage. Ability to interpret and explain rules and regulations that are ambiguous or unclear.
+ Customer Service: A continuing focus on the needs and requirements of customers, anticipating their needs, remaining sensitive to customers while performing services for them, responsive to customer needs.

Salary: The estimated salary for this position is $65,000 - $85,000 per year, depending on experience.

  • Nashville, Tennessee, United States Vanderbilt University Medical Center Full time

    Vanderbilt University Medical Center is a world-renowned institution dedicated to delivering exceptional patient care, education, and research. As a Senior Financial Clearance Specialist at VUMC, you will play a critical role in ensuring the smooth operation of our transplant services.Job SummaryThis position requires an individual with advanced knowledge of...


  • Nashville, Tennessee, United States Vanderbilt University Medical Center Full time

    Senior Financial Clearance SpecialistVanderbilt University Medical Center, a world-renowned medical institution, seeks an experienced Financial Clearance Specialist to join its team in Nashville, Tennessee.As a Senior Financial Clearance Specialist, you will play a vital role in ensuring seamless pre-certification processes for elective surgeries and visits....


  • Nashville, Tennessee, United States Young & Company Business & Wealth Management Full time

    Job OpportunityWe are seeking an experienced Accounting and Financial Expert to join our team at Young & Company Business & Wealth Management. As a key member of our organization, you will be responsible for managing the financial aspects of our clients in the Entertainment Industry.The ideal candidate will have a minimum of 4 years of experience in...


  • Nashville, Tennessee, United States Ventura Aviation Full time

    We are seeking a detail-oriented and experienced Financial Planning Expert to join Ventura Aviation's team. As a key player in the company's financial success, you will be responsible for preparing and analyzing financial data, building and maintaining financial models, assessing risks, and providing strategic insights that drive business growth.The ideal...


  • Nashville, Tennessee, United States Momentum Resource Solutions Full time

    We are looking for a highly skilled Financial Compliance Expert to join our team as a Payroll Operations Specialist. In this role, you will be responsible for ensuring that all payroll-related activities are performed in accordance with federal, state, and local laws and regulations.Key responsibilities include:Reviewing and analyzing payroll data to ensure...


  • Nashville, Tennessee, United States AJ Operations Full time

    Job TitleWe are seeking a highly skilled Financial Administrator to join our team at AJ Operations in Nashville, TN. This role will be responsible for managing the financial facets of our commercial and retail portfolio.About the RoleThe ideal candidate will have 5+ years of experience in commercial real estate, property management, or accounting. They...


  • Nashville, Tennessee, United States Advance Financial Full time

    Advance Financial is seeking a highly motivated and customer-focused Customer Service Representative to join our team!In this role, you'll be responsible for providing exceptional customer service, addressing customer inquiries, and resolving issues in a timely and professional manner. We offer a competitive salary of $16-$24 per hour, with opportunities for...


  • Nashville, Tennessee, United States SOUTH COLLEGE Full time

    About South CollegeSouth College is a growing institution of higher learning with a strong commitment to student success. As a leading provider of undergraduate and graduate healthcare programs, we offer a unique opportunity for professionals to make a meaningful impact in the lives of our students.We are seeking a highly skilled Financial Aid Officer to...


  • Nashville, Tennessee, United States Everstaff Full time

    Everstaff is seeking a skilled Financial Planning & Analysis (FP&A) expert to join our team. As a Financial Planning Specialist, you will play a crucial role in supporting the financial planning, forecasting, and budgeting processes.Key Responsibilities:Assist in preparing monthly, quarterly, and annual financial reports and presentations.Analyze financial...


  • Nashville, Tennessee, United States Advance Financial Full time

    About the RoleAt Advance Financial, we're committed to providing exceptional customer experiences. As a Cash Handling Customer Service Representative, you'll play a vital role in assisting customers with loan applications, ensuring seamless transactions, and delivering top-notch support.What You'll Do:Assist customers with loan applications from start to...


  • Nashville, Tennessee, United States Charlie Health Full time

    About the PositionAs a Cash Posting Specialist, you will play a critical role in ensuring the financial stability of our organization. You will be responsible for accurately billing, reimbursing, and posting patient accounts, resulting in a zero balance. The ideal candidate will have a strong understanding of the revenue cycle process and be able to navigate...


  • Nashville, Tennessee, United States Bank of America Full time

    We are seeking a highly skilled Financial Center Associate to join our team at the Bank of America Financial Center in Nashville, Tennessee. As a key member of our team, you will play a critical role in delivering exceptional client experiences and building strong relationships with our customers.Your primary responsibilities will include engaging clients in...


  • Nashville, Tennessee, United States The Prugar Agency Full time

    Key ResponsibilitiesIn this Financial Services Consultant role, you'll be responsible for developing and executing strategies to grow our business, identifying new opportunities, and providing expert advice to clients.If you're a driven professional with a passion for sales and a desire to make a real difference in people's lives, we'd love to hear from you!


  • Nashville, Tennessee, United States Expert Seekers Training Full time

    Salary and CompensationThe estimated salary range for this position is $60,000 - $100,000 per year, depending on experience and performance. As a commission-based sales representative, you will have the opportunity to earn additional income through successful sales of insurance products.


  • Nashville, Tennessee, United States SHR Talent Full time

    Key ResponsibilitiesThe GAAP Compliance Expert will play a critical role in ensuring that our client's financial records are maintained in accordance with U.S. Generally Accepted Accounting Principles (GAAP).Key responsibilities include:Preparation of financial statements, including balance sheets, income statements, and cash flow statementsAccount...

  • A/P Financial Expert

    2 weeks ago


    Nashville, Tennessee, United States Young & Company Business & Wealth Management Full time

    Position DescriptionWe are looking for an exceptional financial professional to support our clients in the Entertainment Industry, as well as high net worth individuals and small businesses. The successful candidate will have a solid understanding of accounting principles and experience working with Agilink software.The chosen individual will be responsible...


  • Nashville, Tennessee, United States eCapital Full time

    eCapital's VisionWe are a forward-thinking Fintech company dedicated to revolutionizing the freight factoring industry. Our commitment to innovation, excellence, and customer satisfaction drives everything we do.The PositionWe are seeking an experienced Account Manager to join our Customer Service team in the Nashville office. The successful candidate will...


  • Nashville, Tennessee, United States SCOPE Recruiting Full time

    About SCOPE RecruitingWe are a renowned recruitment agency offering expert services to businesses across various industries.Job DescriptionThis senior role involves overseeing key aspects of the Purchased Services Workplan, including strategic development and execution. As a subject matter expert in healthcare services contracting, you will drive cost...


  • Nashville, Tennessee, United States ShiftCode Analytics Full time

    Overview:ShiftCode Analytics is a leading provider of real-time financial market data feeds. We are seeking an experienced C# Backend Developer to join our team and contribute to the design and development of our proprietary software solutions.The ideal candidate will have a strong background in SQL database programming and optimization, as well as...


  • Nashville, Tennessee, United States BC Holdings of Tennessee, LLC Full time

    About Us:BCH Holdings of Tennessee, LLC has been in business for 24 years, serving as a non-fiduciary B2B company. We don't sell products to end-users; we educate. Our mission is to build wealth around the globe, and our culture is built on helping one another on the team and beyond to build wealth the right way.We are seeking a skilled Sales and Account...