10 financial clearance specialist jobs found

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. This position completes all financial clearance activities for services rendered in outpatient departments. Monitors outcomes to ensure medical necessity and authorization requirements are met. Provides feedback to departments on medical necessity and authorization processes. Job Description: Primary Responsibilities: 1. Verifies patient's insurance eligibility for visit, using various online tools and by contacting the payer directly. (essential) 2. Identifies payer medical necessity determination before services are rendered. Informs departments of failed instances. When circumstances dictate, requests additional information to re-run medical necessity check. (essential) 3. Determines authorization requirement and, when necessary, obtains authorization from payer by utilizing payer specific protocols. Requests and coordinates any additional...

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession:  Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas:  Continuously innovate by embracing emerging technology and fostering a culture of creativity and...

The Financial Clearance Specialist serves as a patient liaison for pre-service financial clearance at Dana-Farber Cancer Institute (DFCI) and engagement throughout the patient’s financial experience. Reporting to, and under close direction of, the Access & Financial Engagement Supervisor, the Financial Clearance Specialist is responsible for managing all work related to financial clearance of new or prospective patients at DFCI and ongoing authorization for patients with out-of-network/high risk insurance plans. Working in a fast-paced, high-volume, dynamic environment, the Financial Clearance Specialist will demonstrate a strong understanding of payer coverage policies while applying appropriate payer guidelines to all aspects of out-of-network financial clearance. With guidance, the Financial Clearance Specialist will create accurate authorization requests and thorough and concise documentation, monitor requests for decision and communicate to the appropriate stakeholders,...

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession:  Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas:  Continuously innovate by embracing emerging technology and fostering a culture of creativity and...

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. **Hybrid role** Contribute to the Hospital’s mission by ensuring that all information necessary for proper financial reimbursement for high dollar patient care is analyzed and submitted to insurance companies for approval prior to the patient’s date of service. Collaborate with insurance companies when necessary to proactively validate benefits, eligibility and referral requirements. Communicates with patients to assure they understand their payment obligations and steps necessary to meet these obligations, while maintaining a positive patient experience. Job Description: Consistent with the PROMISE principles and inherent in a hospital environment, employees must be flexible in meeting patients’ and the Hospital’s needs. While the list below describes the primary functions of this job, all employees at Winchester Hospital need to recognize that an...

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession:  Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas:  Continuously innovate by embracing emerging technology and fostering a culture of creativity and...

Overview About the Role The primary purpose of the Program Support Specialist Confidential is to coordinate and provide administrative support for the day-to-day activities of the Medical Staff Affairs and Education Office as it relates to the residents, fellows, students, interns, and shadowing practitioners that rotate through or observe at University Hospital. This position serves as the liaison between University Hospital and the Rutgers NJMS Graduate Medical Education Office, the NJMS Office of Student Affairs, the Careers in Medicine Program, the Chief of Service offices, the training program Directors, and house staff and faculty. Under the direction of the Director, this position collects, monitors, tracks, prepares, verifies and maintains files for residents, students, externs, interns, and shadowing practitioners, including administering guest account, HealthStream, clearance, ID badge, and offboarding processes for incoming and outgoing rotators,...

The primary function of the P/A Follow-Up Biller Specialist is the daily management of an assigned portion of the accounts receivable, typically allocated based on payer and alphabetical splits for Medicare, MassHealth and Other Government insurances. Basic responsibilities include regular and consistent billing or follow-up work on outstanding third-party claims, denial management, verification of accurate reimbursement, and correction and/or reprocessing of claims as necessary. The Billing Specialist should remain in full compliance with all departmental, institutional, and regulatory policies and procedures. Confidentiality is a key function of this role. The Specialist will have regular exposure to patient demographics, diagnostic and billing information. The Specialist may also be called upon to perform other duties as assigned. Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and...

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. The In-Clinic Specialty Medication Access Coordinator is responsible for fulfilling all core job functions while providing dedicated coordination and advanced support for one or more specialty clinics. This position plays a pivotal role in supporting healthcare providers and patients by ensuring timely and seamless access to complex, high-cost, and specialty therapies essential to patient care and quality outcomes. Serving as the primary on-site liaison between providers, patients, and pharmacy, the specialist holds expanded responsibility for enhancing utilization of BILH pharmacy services. The specialist will be expected to proactively identify patients who would benefit from integrated pharmacy support, educate providers and patients on the advantages of internal pharmacy coordination, and leads initiatives that strengthen medication access, adherence, and...

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. This position completes all financial clearance activities for services rendered in outpatient departments. Monitors outcomes to ensure medical necessity and authorization requirements are met. Provides feedback to departments on medical necessity and authorization processes. Job Description: Primary Responsibilities: 1. Verifies patient's insurance eligibility for visit, using various online tools and by contacting the payer directly. (essential) 2. Identifies payer medical necessity determination before services are rendered. Informs departments of failed instances. When circumstances dictate, requests additional information to re-run medical necessity check. (essential) 3. Determines authorization requirement and, when necessary, obtains authorization from payer by utilizing payer specific protocols. Requests and coordinates any additional...