Note: The job is a remote job and is open to candidates in USA. TriHealth is a healthcare organization seeking a Financial Clearance Representative III to support patient financial advocacy and healthcare access. The role verifies insurance coverage and eligibility, obtains authorizations and pre-certifications, estimates patient liability, and reviews medical records to support payment for services rendered.
Responsibilities
- This position is responsible for verifying patient insurance, confirming benefits eligibility, performing authorization and pre-certification, calculating and estimating patient liability, and/or notification as required by third party coverage providers. Purpose of this job is to verify that TriHealth patient insurance information is accurate and up to date so payment will be received for services rendered. Additionally, this position requires the knowledge to review medical records obtaining information such as diagnosis, prior treatment, sign and symptoms, medication and other medical information to submit requests for authorizations for surgery, testing or treatment
- Serve: ALWAYS… • Welcome everyone by making eye contact, greeting with a smile, and saying "hello" • Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist • Refrain from using cell phones for personal reasons in public spaces or patient care areas
- Excel: ALWAYS… • Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met • Offer patients and guests priority when waiting (lines, elevators) • Work on improving quality, safety, and service
- Respect: ALWAYS… • Respect cultural and spiritual differences and honor individual preferences. • Respect everyone’s opinion and contribution, regardless of title/role. • Speak positively about my team members and other departments in front of patients and guests
- Value: ALWAYS… • Value the time of others by striving to be on time, prepared and actively participating. • Pick up trash, ensuring the physical environment is clean and safe. • Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste
- Engage: ALWAYS… • Acknowledge wins and frequently thank team members and others for contributions. • Show courtesy and compassion with customers, team members and the community
Skills
- High School Degree in Medical terminology course or equivalent knowledge
- Knowledge of Medical Terminology
- Insurance vocabulary and processes
- Government and Non-government third party benefits and coverage rules
- Understanding of the impact financial clearance services has on revenue cycle operations and financial performance
- 1-2 years experience Customer Service Healthcare
- Dedication to treating both internal and external constituents as clients and customers
- Maintaining a flexible customer service approach and orientation that emphasizes service satisfaction and quality
- Background in managed care or patient billing
- 1-2 years experience Technical Healthcare
- Must have one year experience in insurance verification or precertification experience
- Experience with automated patient account system or online verification systems
- Climbing - Rarely
- Concentrating - Consistently
- Continuous Learning - Frequently
- Hearing: Conversation - Consistently
- Hearing: Other Sounds - Rarely
- Interpersonal Communication - Consistently
- Kneeling - Rarely
- Lifting <10 Lbs - Rarely
- Lifting 50+ Lbs - Rarely
- Lifting 11-50 Lbs - Rarely
- Pulling - Rarely
- Pushing - Rarely
- Reaching - Occasionally
- Reading - Consistently
- Sitting - Frequently
- Standing - Occasionally
- Stooping - Occasionally
- Talking - Consistently
- Thinking/Reasoning - Consistently
- Use of Hands - Consistently
- Color Vision - Rarely
- Visual Acuity: Far - Consistently
- Visual Acuity: Near - Consistently
- Walking - Frequently
Benefits
- Work from home
- Competitive shift differentials
- Opportunities for professional growth
- Medical benefits may be included in the comprehensive benefits package
- Dental benefits may be included in the comprehensive benefits package
- Vision benefits may be included in the comprehensive benefits package
- Paid time off may be included in the comprehensive benefits package
- Retirement savings plans may be included in the comprehensive benefits package
- Tuition reimbursement may be included in the comprehensive benefits package
- PRN positions not eligible for TriHealth benefits
Company Overview
Company H1B Sponsorship