Financial Clearance Specialist

Umass Memorial Health Caregiver

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Everyone Is a Caregiver

At UMass Memorial Health, everyone is a caregiver regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.

This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.

Major Responsibilities:

1. Initiates contact with insurance companies to obtain eligibility, gather accurate patient billing information, and performs collections with outstanding accounts receivable.

2. Accurately estimates the patient financial liability (copayments, deductibles, coinsurances, deposits, etc. via obtaining accurate demographic and financial information). Answers patient inquiries regarding their liability and able to explain the variables involved.

3. Receives and processes patient payments.

4. Ensures pre-certification authorization and or referral is in placement prior to service being rendered.

5. Appropriately referring patients to Financial Counselors or Business Office dependent on need of patient.

6. Reschedules appointments when requested by patient or, under advisement of department leader, when due to financial circumstances appointment requires postponement.

7. Enters clear, concise notes concerning financial clearance status in system based on communications.

8. Demonstrate knowledge and understanding of all job-related policies and procedures and adheres to and consistently applies the Financial Clearance Policy in all patient cases.

9. Assesses gaps in patient coverage to determine patient financial exposure prior to rendering service.

10. Consistently demonstrates ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary.

11. Performs other duties as assigned, or directed, to ensure smooth operation of the department/unit.

Position Qualifications:

License/Certification/Education: Preferred:

1. Minimum High School Diploma, or G.E.D., business concentration preferred.

2. Associate degree, or higher, preferred.

Experience/Skills: Required:

1. Four plus (4+) years of experience within a business office setting, hospital revenue cycle preferred, Physician office or collection agency.

2. Prior experience in a healthcare environment required.

Physical Demands and Environmental Conditions:

On-the-job time is spent in the following physical activities:

1. Stand - 1/3

2. Walk - 1/3

3. Sit - 2/3

4. Talk or hear - 2/3

5. Uses hands to finger, handle or feel - 2/3

This job requires that weight be lifted, or force be exerted:

1. Up to 10 pounds - 1/3

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We're striving to make respect a part of everything we do at UMass Memorial Health for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.

As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.

If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at View email address on click.appcast.io. We will make every effort to respond to your request for disability assistance as soon as possible.