Financial Clearance Specialist III

Financial Clearance Specialist III

Under the general direction of a supervisor or manager, responsible for performing pre-registration functions and obtaining authorizations from various insurance carriers. This role requires a high level of independent judgement in order to successfully coordinate and obtain authorization requests for complex managed care patients in a timely and efficient manner. This individual is expected to utilize telecommunications and computer information systems to pre-register patients, verify information and insurance, and obtain authorizations. The Financial Clearance Specialist is best defined as a highly independent and flexible resource that focuses on system-specific service lines that are in alignment with the patient experience initiative. Furthermore, this role must multi-task between different patient care areas to ensure an extraordinary patient experience and that quality standards are met. Additional duties include but are not limited to physician and patient communication serving as an information resource.

Positions include:

• Authorization experience
• Performs other departmental duties as assigned, such as answering and making phone calls, managing incoming/outgoing faxes, organizing and filing departmental documents, data entry, etc.
• Referral Coordination
• Pre-Registration
• Customer Service
• Multi-specialty HEM/ONC, URO, SUR ONC, GYN ONC etc.

Minimum Qualifications & Experience:

• Three years of health insurance experience, and authorization experience is a must. The ability to communicate with physicians, patients, and health plans. Experience with electronic medical records, medical terminology, CPT codes and ICD-10 codes. Billing experience will be considered.
• At least two years front desk oncology practice experience registering patients and
• EPIC EMR experience.

Minimum Education:

• High School Diploma,
• Three years related healthcare authorization/pre-registration/Insurance verification/referral experience required.
• Medical terminology and electronic medical record experience required.

Location:

• Position will be on a hybrid work from home and office rotation. (All training is on site at our Irwindale location)

Schedule:

8:30am-5pm

FTE Conversion/Extension possibility?

YES

Interview Type (phone, Teams, in-person, etc.):

Teams

Additional Comments:

• Looking for a responsible reliable employee who's a team player with a positive attitude! Chemotherapy experience is a plus!
• Maintains appropriate level of productivity and accuracy for work performed based on department standards. Reliable individual who maintains thorough knowledge of policies, procedures, and standard work within the department in order to successfully performance duties on a day-to-day basis.

Position Comments:

• Requesting Chemotherapy authorization experience
• Must be based on the West Coast
• Recent Epic EMR experience
• Strong background submitting and reviewing chemotherapy and episode-based medication authorizations, including treatment plan and clinical documentation review
• Experience with insurance and benefit verification
• Experience working with major insurance plan web portals
• Proficiency with Microsoft Teams, Outlook, Excel, and Adobe Acrobat Pro