Financial Clearance Representative

Central Maine Healthcare • Lewiston, ME

1d

About The Position

Central Maine Healthcareis seeking a Full Time, Patient Financial Clearance Representative to join our team in Lewiston!
Position Summary:
The Financial Clearance Representative (FCR) is responsible to ensure patients presenting for services are financially cleared prior to service. This is to include pre-registration, validating eligibility and benefits, referral, prior authorization, price estimating, obtain or provide payment options pre-service and communicating with the patient and/or collaborating with the practice or department.

Requirements

• High School graduate
• Minimum of three years relevant or medical office experience
• Health insurance knowledge

Nice To Haves

• Knowledge of medical terminology preferred

Responsibilities

• Complete validation process prior to service which includes full pre-registration, eligibility, benefit verification and price estimator, contacting insurance plans to obtain prior authorization and medical policies.
• Process referrals and prior authorizations within 24-48 hours of receipt of the task.
• Accurately document and report completions of process following standard work of Financial Clearance.
• Identify, interpret and communicate findings that do not meet financial clearance criteria.
• Communicate to the appropriate department, practice or provider when key data elements including medical necessity are missing or not met that require review to continue with the clearance process.
• Communicate payment risk and collaborate with Financial Counselors to complete the financial clearance process.
• Engage management when issues or concerns result in failure to meet deadlines or financial clearance expectations.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED