Financial Clearance Center Specialist

Job Description

Job Description

Overview

The Financial Clearance Center (FCC) Specialist contacts insurance companies, branch operations, and patients to ensure accurate patient demographic and insurance information including insurance verification/benefits/authorizations, and the status of a used/remaining benefits.

Responsibilities

Responsibilities
• Verifies Eligibility and insurance benefits using electronic and telephonic resources, communicating and identified insurance plan changes to billing managers for system updates.
• Obtains pre-certification, authorizations, and referrals to ensure managed care compliance for necessary services.
• Fulfills notification requirements for admissions
• Contacts patients to request and obtain patient liabilities, establishing patient plans as requested.
• Works closely with various departments throughout the organization, including Business HUB, Clinical Coordinators and Branch Operations.
• Provides patient education concerning patient rights, regulatory requirements and financial policies.
• Preparing oral/written communications including periodic status reports
• Document notes in computer system regarding all conversations with patients, insurance company representatives, and pre-certification notification representatives.
• Supports BrightSpring Health’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FCRA, and other laws applicable to BrightSpring Health’s business practices. This includes becoming familiar with BrightSpring health’s Code of ethics (LEGACY), attending training as required, notifying management or BrightSpring Health’s helpline when there is a compliance concern or incident, HIPAA- complaint handling of patient information, and demonstrable awareness of confidentiality obligations.

Qualifications

• High School diploma or GED
• 1+ year of experience in a role that interfaces with commerical or government insurance payers to verify medical coverage or to perform billing, collections or follow up activities on covered charges for patients.
• Strong analytical skills to process admissions and appropriately calculate patient liability.
• Demonstrated ability to navigate Internet Explorer and Miscrosoft Office.
• Demonstrated experience communicating effectively with a customer and simplifying complex information.