Patient Financial Clearance Representative

🕒 August 10

⚔️ Virginia – Remote

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⏰ Full Time

🟡 Mid-level

🟠 Senior

💸 Financial Planning and Analysis (FP&A)

🦅 H1B Visa Sponsor

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👻 Ghost score 31%

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Logo of VCU Health

VCU Health

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

VCU Health is an academic medical center dedicated to advancing medicine and improving community health. With over 800 physicians across 200 clinical specialties, it offers a wide range of services including cancer care, heart and vascular services, neurosciences, orthopaedics, pediatrics, emergency care, and telehealth. VCU Health integrates cutting-edge technology and clinical expertise to make medical advancements a reality. It operates various hospitals and comprehensive care centers, including the VCU Medical Center in Downtown Richmond and the Children's Hospital of Richmond. VCU Health also emphasizes research and clinical trials to push the boundaries of what's possible in medicine.

📋 Description

• Perform the full scope of financial clearance activities for assigned patients before scheduled appointments • Confirm completeness of patient registration data and update demographic and insurance information • Verify insurance eligibility and benefits using system and web-based tools, and contact payers and patients as necessary • Calculate out-of-pocket liability and collect deposits, co-pays, deductibles, and outstanding balances before service • Refer patients to financial counselors when assistance is needed to identify alternate payer sources or establish payment plans • Contact primary care physicians to secure required PCP referrals • Contact health plans to secure prior authorization for procedures and testing • Coordinate peer-to-peer reviews between VCUHS physicians and health plan medical directors • Prepare forms required to obtain third-party payer payment • Determine when to apply additions or revisions to patient accounts and current visits • Communicate patient financial responsibility clearly and transparently • Support streamlined clinical workflows and improved revenue cycle operations and financial performance

🎯 Requirements

• Minimum three (3) years of previous experience in a health care setting • Experience with commercial, managed care, and governmental health insurance plans • One (1) year of experience in insurance plan authorization and referral requirements, or medical billing experience • Previous experience using a personal computer and software applications, including Microsoft and email • Strong customer service skills and patient/customer-centered focus • High School Diploma or equivalent • Preferred: GE-IDX Patient Registration or other medical billing/registration system experience • Preferred: ICD and CPT coding experience • Preferred: Medical terminology experience • No licensure, certification, or registration required • May require work hours to periodically extend to 8:00 p.m. • Ability to lift 20–50 lbs. • Prolonged sitting, reaching, repetitive motion, and prolonged PC/keyboard usage • Strong recall, reasoning, problem solving, clear speech, legible writing, reading, and logical thinking • Ability to concentrate/focus, handle multiple priorities, manage frequent and intense customer interactions, and adapt to frequent change

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