Specialist II, Financial Clearance, Pt. Access

Role Description

Specialist II, Financial Clearance, Pt. Access – St. Mary's Hospital – Per Diem Days - Remote

Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization’s strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge.

Essential Functions

• Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions.
• Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution.
• Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience.
• Responsible for distribution of analytical reports.
• Utilizes multiple system applications to perform analysis, create reports & develop educational materials.
• Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge.
• Research & compiles information to support ad-hoc operational projects & initiatives.
• Synthesizes & analyzes data & provides detailed summaries including graphical data presentations illustrating trends & recommending practical options or solutions.
• Maintains a working knowledge of applicable federal, state & local laws/regulations, Trinity Health Integrity & Compliance Program & Code of Conduct.

Qualifications

• High School Diploma or equivalent.
• Two (2) to Five (5) years experience in area of expertise such as scheduling, financial clearance, or patient access.
• National certification in HFMA CRCR or NAHAM CHAA required within one (1) year of hire.
• Must be proficient in the use of Patient Registration/Patient Accounting systems and related software systems.

Requirements

• Minimum of five (5) years of financial clearance/authorization experience in an acute care setting.
• Experienced in processing financial clearance for complex services including surgical services, observation, and in-house cases.
• Experienced in complex facility-based ancillary testing across multiple facilities/states.
• Responsible for complex, high-dollar services including surgical, observation and in-house services.

Additional Qualifications

• Associates Degree, preferred.
• Comprehensive knowledge of scheduling with mastery in at least three (3) or more modalities and insurance verification processes with three (3) years scheduling experience in an acute care setting.
• Strong knowledge of third-party and government payer billing and reimbursement guidelines.

Physical & Mental Requirements & Working Conditions

• Exposure to conditions which may be considered unpleasant to sight, touch, sound & / or smell.
• Occasional exposure to fumes, odors, dusts, mists & gases, biohazards/hazards.
• Frequent exposure to interruptions, shifting priorities & stressful situations.
• Ability to follow tasks through to completion, understand & relate to complex ideas/concepts.
• Continuous ability to read small print, hear sounds & voice/speech patterns.
• Frequent manual dexterity activities & / or grasping/handling.
• Occasional ability to climb, kneel, crouch & / or operate foot controls.
• Continuous use of a computer/other technology.
• Frequent maintenance of a safe working environment & use of available personal protective equipment (PPE).
• Occasional ability to provide assistance in the event of an emergency.

Pay Range

$19.20-$24.60 based on experience, skills, and education.

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.