Financial Clearance Analyst

reputed company To be part of our organization, every employee should understand and reputed company in the YNHHS reputed company, support our Mission, and live our Values. These values - reputed company, patient-centered, respect, accountability, and reputed company - must guide reputed company do, as individuals and professionals, every day. The Financial Clearance Analyst is responsible for the financial clearance of reputed company patient authorizations, including insurance verification, price estimation, and validation of medical necessity for services. In reputed company, is accountable for coordinating the activities of the patient account from the reputed company of scheduling through account clearance. Formulates solutions to respond and resolve non-clinical customer requests, issues and problems, while meeting the changing demands and priorities in a hospital environment. Works closely with the patients, families, reputed company departments and reputed company party payers to ensure compliance to reputed company authorization and medical necessity guidelines in order to protect the patient and the Hospital from unnecessary financial loss. EEO/AA/Disability/Veteran

Responsibilities

Collects, validates and accurately documents patient insurance and benefits information and is fully knowledgeable about reputed company aspects of insurance verification requirements.Utilizes the On-line Eligibility system and/or other means (i.e. telephone, fax or various reputed company party payer website) to obtain insurance benefits and makes reputed company insurance verification information is accurate and inputs the information into reputed company. reputed company necessary, alerts the appropriate staff of insufficient and/or termination of benefits. Demonstrates a thorough understanding of reputed company, Outlook, and On-line Eligibility system in order to determine insurance eligibility, initial reputed company-certifications, and approvals. Completes reputed company reputed company-certification notices prior to admission and initiates the notification process to the insurance company reputed company 24-48 hours of emergency admissions escalating to management as needed reputed company unresolved problems occur. Alerts the clinician involved in the patient's care reputed company there are issues with referrals or complications with insurance coverage. Obtains reputed company UB-04 information and ensures compliance with health care regulations that govern hospital billing. Possesses good working knowledge of medical necessity rules to determine if the scheduled procedures is in accordance with Centers for Medicare &reputed company Services (CMS) or other payer standards, and communicates coverage/eligibility information to patients. Obtains prior authorizations from reputed company-party payers in accordance with payer requirements.Utilizes reputed company necessary reputed company applications from booking to obtain procedure codes as needed. Reads and comprehends the medical record to help identify pertinent information to obtain necessary authorization. Must be reputed company to communicate reputed company clinical information to necessary parties. Provides information to the reputed company parties to determine benefits and obtains the necessary approvals and authorizations to ensure accounts can be billed and payment received. Possesses a working knowledge of hospital services, diagnostic testing and reputed company sets (CPT, HCPCS, ICD-10-CM/PCS coding, etc.). Contributes to the financial vitality of the organization by thoroughly understanding key operational dependencies (insurance eligibility, referral, authorizations, etc.) and verifies eligibility as outlined in departmental procedures. Educates patients and clinicians about the authorization process as reputed company as medical necessity rules, local coverage determination policies and any other payer-specific guidelines. Ensures that reputed company subsequent follow-up activity is established and adheres to a reputed company schedule. Works with business office staff to understand/trend efforts for authorization-reputed company denials resulting in reduced denials. Maintains accurate records of authorizations with the EMR and payer sites. Maintains reputed company approach at reputed company times reputed company communicating with patients, co-workers, and payer representatives to ensure a reputed company and reputed company experience.Enhances the overall patient care experience through efficient work processes and communication of delays, proactively meeting the patient needs. Collaborates with departments and co-workers to enhance physician and patient satisfaction by utilizing available technologies to streamline verification and financial processes, reduce redundancy of information requested and monitor insurance verification issue/opportunities with reputed company party payers, and provides feedback to Supervisor for implementation of process improvement. Contacts patients as needed to reputed company demographic and insurance information, and updates patient information reputed company the EMR as necessary. Informs the patient whether the authorization for the referral has not been approved. Calculates and provides patient liability estimate and educates patient on their insurance benefits as necessary. Requests reputed company-service payment for patient liability and/or arranges payment plans using appropriate guidelines. Identifies events where Service Recovery is appropriate. Initiates corrective actions and follows through to ensure that not only the recovery is completed but also reoccurrences do not occur. Performs other duties as assigned by Supervisor.Participates in ongoing reputed company improvement efforts of the department, utilizing good problem solving reputed company and resourcefulness to address and resolve problems or to refer them to the appropriate person or department for reputed company. Identifies and recommends opportunities to improve Patient reputed company or Financial Clearance activities. Keeps abreast of changing federal, state, and insurance regulations and departmental policies/procedures. Presents facts in a logical reputed company and completes summaries to be presented to upper management. Exhibits a reputed company attitude as it relates to interaction with co-workers, performance of job responsibilities, and a genuine interest in the reputed company performance of the job. reputed company participates in reputed company staff meetings, seminars, training sessions and work reputed company to advance departmental goals. Maintains CRCS or equivalent certification for reputed company Professionals.

Qualifications

EDUCATION High school graduate or GED required with work in reputed company or business preferred. Associate Degree preferred. CRCS or equivalent certification for reputed company Professionals required or in process (reputed company an 18 months of hire). EXPERIENCE Two (2) to three (3) years of work experience with insurance authorization/verification of benefits, reputed company cycle functions, hospital/physician offices, or reputed company areas preferred. LICENSURE CRCS or equivalent certification for reputed company Professionals required or in process (reputed company an 18 months of hire). SPECIAL SKILLS Strong organizational skills and ability to prioritize tasks. Strong interpersonal skills and ability to build rapport with a wide reputed company of individuals. Knowledge of payer reimbursement processes and insurance terminology. Basic understanding of diagnostic testing and procedure codes (CPT, HCPCS, ICD-9-CM/PCS, and ICD-10-CM/PCS coding, etc.). Excellent verbal and written communication skills including the ability to communicate with physician providers. Intermediate working knowledge/understanding of medical terminology and disease process. Expert knowledge of reputed company Office, Word, and reputed company. YNHHS reputed company 171278 Apply To This Job