Financial Clearance Specialist

Description The Financial Clearance Specialist II is responsible for all pre‑service accounts’ financial clearance and collection prior to the date of service. Employment Type Full time Shift Day Shift Minimum Qualifications High School Diploma or equivalent. Two to Five years experience in scheduling, financial clearance, or patient access. National certification in HFMA CRCR required within one year of hire. Proficiency in Patient Registration/Patient Accounting systems and related software. Additional Qualifications Associate’s degree preferred. Comprehensive knowledge of scheduling with mastery in at least three modalities and insurance verification processes; three years scheduling experience in an acute care setting. Experience in complex facility‑based ancillary testing across multiple facilities and states. Strong knowledge of third‑party and government payer billing and reimbursement guidelines and department performance standards and policies and procedures. Physical & Mental Requirements & Working Conditions Exposure to unpleasant conditions, fumes, odors, dust, mists, gases, biohazards, noise, infectious waste, diseases—occasional or frequent. Ability to follow tasks through completion, understand complex concepts, handle long periods and concurrent tasks—continuous. Manual dexterity activities—occasional or frequent. Use of computer and other technology—continuous. Compliance with Trinity Health’s Code of Conduct, policies, procedures and guidelines—continuous. Essential Functions Perform insurance eligibility/benefit verification using EDI transactions, payer web access, or direct calls; document results in EMR. Determine need for authorizations and contact physician, Case Management or Utilization Review as necessary. Inform patient/guarantor of liabilities and collect payments (co‑payments, co‑insurances, deductibles, deposits, balances) at pre‑registration; provide receipts. Validate medical necessity of Medicare and non‑Medicare cases to ensure clinical and financial clearance. Coordinate with scheduling and ancillary departments for diagnosis or test clarification. Prepare special reports for manager and assist with workload demands or training new employees. Maintain knowledge of federal, state, and local laws and Trinity Health policies for ethical practice. Required training: uninterrupted 4 weeks. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person‑centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law. #J-18808-Ljbffr Trinity Health