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Financial Clearance Specialist
Trinity HealthFinancial Clearance Specialist managing patient financial accounts and verifications for services at Trinity Health. Involves extensive interaction with insurance verification and financial collections.
About the role
Key responsibilities & impact- The Financial Clearance Specialist II is responsible for all pre-service accounts' financial clearance and collection prior to the date of service.
- Obtains and verifies accurate insurance information, benefit validation, authorization, and preservice collections.
- Begins the overall patient experience and initiates the billing process for services provided by the hospital.
- Responsible for complex, high-dollar services including surgical, observation and in-house services working in multiple areas of verification including outpatient verification, elective short procedure / inpatient verification, & urgent admission verification or scheduling.
- Performs insurance eligibility/benefit verification, utilizing a variety of mechanisms (primarily EDI transactions and payer web access, and in some cases by calling payers directly) and documenting information within the EMR system.
- Determines need for appropriate service authorizations (pre-certifications, 3rd party authorizations, referrals) and will contact the physician and Case Management/Utilization Review personnel, as necessary.
- Informs patient/guarantor of their liabilities and collects appropriate patient liabilities, including co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of pre-registration.
Requirements
What you’ll need- High School Diploma or equivalent.
- Two (2) to Five (5) years experience in area of expertise such as scheduling, financial clearance, or patient access.
- National certification in HFMA CRCR required within one (1) year of hire.
- Must be proficient in the use of Patient Registration/Patient Accounting systems and related software systems.
- Associate's degree is preferred.
- Comprehensive knowledge of scheduling with mastery in at least three (3) or more modalities and insurance verification processes with three (3) years scheduling experience in an acute care setting.
- Strong knowledge of third-party and government payer billing and reimbursement guidelines as well as department performance standards and policies and procedures.
Benefits
Comp & perks- Exposure to conditions which may be considered unpleasant to sight, touch, sound & / or smell.
- Occasional Exposure to fumes, odors, dusts, mists & gases, biohazards / hazards (mechanical, electrical, burns, chemicals, radiation, sharp objects, etc.).
- Occasional Exposure to or subject to noise, infectious waste, diseases & conditions.
- Comply with Trinity Health’s Code of Conduct, policies, procedures & guidelines.
- Ability to provide assistance in the event of an emergency.
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Insurance Eligibility VerificationBenefit ValidationPre-Service CollectionsService AuthorizationsPatient Liability CollectionEDI TransactionsEMR DocumentationScheduling MasteryPayer Web AccessThird-Party Billing Guidelines
Soft Skills
Communication SkillsInterpersonal SkillsAttention to DetailProblem-Solving SkillsCustomer Service Orientation
Certifications
HFMA CRCR Certification