Financial Clearance Specialist

About Shepherd Center With five decades of experience, Shepherd Center provides world-class clinical care, research, and family support for people experiencing the most complex conditions, including spinal cord and brain injuries, multi-trauma, traumatic amputations, stroke, multiple sclerosis, and pain. An elite center ranked by" U.S. News "as one of the nation's top hospitals for rehabilitation, Shepherd Center is also recognized as both Spinal Cord Injury and Traumatic Brain Injury Model Systems. Shepherd is the only rehabilitation facility in the nation with an intensive care unit on-site, allowing us to care for the most complex patients and begin the rehabilitation process sooner. Shepherd Center treats thousands of patients annually with unmatched expertise and unwavering compassion to help them begin again. Shepherd Center's culture is one of hope, humor, and hard work. You will enjoy career growth, strong relationships with co-workers , strong support from leadership, and fun activities that have ke pt over 1 2% of staff members working at Shepherd for more than 20 years . The Financial Clearance Specialist is responsible for ensuring patients are financially cleared prior to services by verifying insurance coverage, interpreting benefits, coordinating authorizations, delivering estimates, and providing financial counseling. This role serves as a key liaison between Patient Access Services, Patient Financial Services, and patients to reduce financial risk, ensure regulatory compliance, and enhance the patient's financial experience. JOB RESPONSIBILITIES Provide expert guidance to patients and families by explaining insurance benefits, coverage limitations, estimates, and financial responsibility for planned or received servicesInterpret and explain benefits, explanations of benefits (EOBs), authorizations, denials, and payer determinations to patients and familiesDocument benefit details, estimates, and financial discussions accurately within the EHREnsure compliance with CMS-required notices, the No Surprises Act, and price transparency requirements, including delivery and explanation of patient estimatesEstablish and negotiate payment plans with patients as appropriate and in accordance with organizational policyServe as the first point of contact for explaining Shepherd Center's Financial Assistance Program (FAP) and coordinate submission of required documentationPerform POS collections, maintain cash drawer accuracy, process credit card transactions, and communicate effectively with patients and guarantors regarding balancesCollaborate closely with Insurance Verification Specialists, escalating complex coverage, authorization, or financial clearance issues as neededReceives escalations from Insurance Verification Specialists for complex financial clearance scenariosPartner with Patient Financial Services, Case Management, Managed Care, and insurance carriers to resolve complex financial and coverage scenariosMeet with patients and families in clinics or at the bedside as required, demonstrating compassion, professionalism, and financial expertiseAnswer incoming calls, respond to voicemails and emails, and route patient inquiries appropriately in a timely mannerMaintain working knowledge of registration workflows and provide cross-coverage support for outpatient clinics as neededPractices proper safety techniques in accordance with Center and departmental policies and procedures. Responsible for the reporting of employee/patient/visitor injuries or accidents, or other safety issues to the supervisor and in the occurrence notification system. Monitors and ensures compliance with all regulatory requirements, organizational standards, and policies and procedures related to area of responsibility. Identifies potential risk areas within area of responsibility and supports problem resolution process. REQUIRED MINIMUM EDUCATION High School Diploma or GED required REQUIRED MINIMUM CERTIFICATION N/A REQUIRED LICENSURE N/A REQUIRED MINIMUM EXPERIENCE 3-5 years of progressive experience in patient access, financial clearance, healthcare billing, or related revenue cycle functions, preferably in a hospital or physician enterprise. REQUIRED MINIMUM SKILLS Strong working knowledge of commercial, managed care, and governmental insurance plansDemonstrated ability to interpret benefits, authorizations, and payer determinations independentlyStrong math aptitude and financial acumenExcellent written and verbal communication skillsProficiency with Epic and Microsoft Office toolsAbility to manage sensitive financial conversations with professionalism and empathy PREFERRED QUALIFICATIONS Associates or Bachelor's degree preferredCPAR or CHAA preferredCHAM or HFMA CRCR a plus PHYSICAL DEMANDS Sedentary work with occasional standing, walking, or lifting up to 15 pounds. WORKING CONDITIONS No potential for exposure to blood and body fluids. #J-18808-Ljbffr