Medical Billing, Financial Clearance Specialist
Solaris Health
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- The Financial Clearance Specialist is responsible for ensuring patients are financially cleared prior to receiving services by verifying insurance eligibility and obtaining prior authorizations.
- Verify insurance coverage and benefit information using payer portals, clearinghouses, and direct communication with insurers.
- Confirm plan status, effective dates, co-pays, deductibles, coinsurance, and authorization requirements.
- Accurately document verification results in the EHR and/or PM.
- Submit prior authorization requests for services, tests, and procedures based on payer requirements.
- Monitor and follow up on pending authorizations to avoid delays in patient care.
- Address denied or delayed authorizations with payers and escalate unresolved issues to the Supervisor as needed.
- Coordinate with clinical staff to gather and submit necessary documentation for authorization approval.
- Notify appropriate teams of coverage issues, authorization status, or patient financial risk.
- Communicate with patients regarding their insurance coverage, financial responsibilities, and authorization outcomes when appropriate.
- Collaborate with schedulers and front-desk teams to ensure appointments align with insurance requirements.
- Follow standardized workflows and documentation protocols as outlined by the Supervisor.
- Maintain accuracy and timeliness in all financial clearance documentation.
- Participate in daily team huddles and contribute to process improvement initiatives.
- Performs other position related duties as assigned.
Requirements
- 1–3 years of experience in insurance verification, medical authorizations, or revenue cycle operations.
- Knowledge of commercial, Medicare, Medicaid, and managed care insurance plans.
- High School Diploma or equivalent required. Associate’s degree in healthcare, business, or related field preferred.
- Strong attention to detail and organizational skills.
- Proficiency in EHR systems, payer portals, and Microsoft Office.
- Excellent communication and problem-solving abilities.
- Professional verbal and written communication skills.
- Knowledge of medical terminology, healthcare coding systems, and clinics functions.
Benefits
- Health insurance
- Dental insurance
- Vision insurance
- Life Insurance
- Pet Insurance
- Health savings account
- Paid sick time
- Paid time off
- Paid holidays
- Profit sharing
- Retirement plan
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
insurance verificationmedical authorizationsrevenue cycle operationsEHR systemspayer portalshealthcare coding systemsmedical terminology
Soft skills
attention to detailorganizational skillscommunication skillsproblem-solving abilitiesverbal communicationwritten communication
Certifications
High School DiplomaAssociate’s degree in healthcareAssociate’s degree in business