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Financial Clearance Specialist

2 months ago

Montgomery, Alabama, United States Baptist Health Full time

Baptist Health is a leading healthcare organization serving central Alabama, providing comprehensive hospital-based and outpatient services to nearly 60 percent of the residents in the region. Our mission is to deliver high-quality patient care and exceptional service to our community.

The Financial Clearance Specialist is a critical role within our organization, responsible for ensuring that patient accounts are financially cleared prior to service. This involves demonstrating proficiency in all phases of financial clearance, including:

  • Scheduling and insurance verification
  • Price estimation and authorization
  • Pre-certification and medical necessity
  • Maintaining a proficient understanding of third-party payer regulations and guidelines

The ideal candidate will have a strong understanding of hospital billing and revenue cycle processes, as well as excellent communication and interpersonal skills. They will be able to work independently and as part of a team to ensure seamless patient access and financial clearance.

Key Responsibilities:

  • Verify patient insurance coverage and benefits
  • Estimate patient financial responsibility and obtain authorizations
  • Ensure compliance with third-party payer regulations and guidelines
  • Collaborate with healthcare teams to resolve patient access and financial clearance issues
  • Participate in denial analysis and improvement initiatives

Requirements:

  • High school graduate or equivalent required; preferred post-secondary education
  • Minimum 2 years of experience in a healthcare business office setting
  • Hospital revenue cycle experience preferred
  • Previous cash collections experience is preferred
  • Certification preferred: CPAR or CHAA
  • Knowledge of hospital billing and revenue cycle
  • Ability to manage multiple tasks simultaneously with minimal supervision
  • Strong interpersonal, oral and written communication skills
  • Knowledge of common office software
  • Ability to work in a fast-paced, often stressful environment
  • Ability to work in a 24-hour department with varying shifts, days, and holidays
  • The ability to de-escalate sensitive and rapidly changing situations
  • Knowledge of federal, commercial, and managed care payers