Revenue Cycle Associate – Financial Clearance

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🔥 0 minutes ago

🏄 California, Kentucky, +8 more states – Remote

🏄 California – Remote 🐎 Kentucky – Remote 🎰 Nevada – Remote 🌶️ New Mexico – Remote 🌲 Oregon – Remote 🍂 Massachusetts – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🦬 Wyoming – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

💸 Financial Planning and Analysis (FP&A)

🚫👨‍🎓 No degree required

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Quorum Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2016

🏥 Healthcare

👥 B2C

Healthcare • B2C

Quorum Health is an operator of general acute care hospitals that owns or operates 12 hospitals across nine U. S. states. The company partners with local providers and subsidiaries to deliver inpatient and community-based healthcare services, focusing on quality, safety, and supporting local economies and workforce development. Quorum Health emphasizes community investment, hospital administration, and empowering local teams to provide patient-centered care.

📋 Description

• Ensure financial clearance, including verification of eligibility and benefits and securing prior authorization, before the patient’s date of service • Perform coverage discovery to identify additional insurance coverage when existing insurance is inactive • Calculate and clearly document patient liability estimates • Provide payers with timely inpatient and observation Notices of Admission according to payer-specific guidelines • Validate prior authorization and follow up with providers by phone when required • Verify medical necessity and identify when a Medicare Advance Beneficiary Notice of Noncoverage is required • Escalate cases where financial clearance may not be obtained to appropriate stakeholders • Resolve insurance coverage and authorization discrepancies identified by automated quality assurance tools • Work assigned denials related to referrals, authorizations, notifications, non-coverage, and medical necessity, including coordinating rebills or appeals and obtaining retro authorization • Observe privacy, safety, and security procedures and properly use equipment and materials • Work accurately and timely in a remote call center environment while providing exceptional customer service • Interact with providers, payers, patients, and hospital-based personnel

🎯 Requirements

• Proficient in typing • General knowledge of medical terminology • Ability to communicate effectively and professionally in English, verbally and in writing • Critical thinking and problem-solving skills • High school graduate or equivalent • Ability to work within a remote call center environment free from distractions and background noise • One year of related medical-field experience preferred

🏖️ Benefits

• Competitive salary and benefits package • Opportunities for professional development and advancement • Supportive work environment with a collaborative team • Comprehensive healthcare coverage • Retirement savings plan • Paid time off and flexible scheduling options • Student loan repayment program