Patient Financial Clearance Representative I

🔥 16 hours ago

🏄 California – Remote

🏄 California – Remote

💵 $34 - $38 / hour

⏰ Full Time

🟢 Junior

💸 Financial Planning and Analysis (FP&A)

🚫👨‍🎓 No degree required

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Stanford Health Care

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1885

🏥 Healthcare

⚕️ Healthcare Insurance

📚 Education

Healthcare • Healthcare Insurance • Education

Stanford Health Care is a major academic medical center affiliated with Stanford Medicine. It provides world-renowned patient care, emphasizes innovation and research, and offers a wide range of clinical services and career opportunities across nursing, advanced practice, allied health, laboratory, technology, administration, and other areas. The organization promotes values such as C-I-CARE (respect, courtesy, personal connection), sustainability, dedication, and community collaboration across physicians, researchers, professors, and students to advance health, healing, and knowledge globally.

📋 Description

• Complete insurance verification, eligibility, and benefit determinations using electronic eligibility systems, payer websites, and phone • Interpret and document co-pays, deductibles, share of cost, co-insurance, maximum benefit levels, and available days • Contact patients to obtain and update information • Complete Medicare Secondary Questionnaires as appropriate • Apply authorization rules and requirements for payors in assigned work queues • Develop knowledge of procedures and diagnoses for assigned service lines to complete authorizations • Assess authorization and sponsorship data requirements and communicate with clinics and referring providers • Follow up on pending authorizations and referrals to secure timely sponsorship • Coordinate peer-to-peer appeal reviews with payor utilization management • Prioritize work to minimize financial risk, meet authorization timelines, and achieve daily productivity goals • Identify and escalate coverage, benefit, and financial-clearance risks • Refer cases to financial counseling when authorization is not secured timely • Notify management of errors, issues, or obstacles • Document accounts and communicate through emails, internal notes, and memos • Manage inbound and outbound phone calls and respond to customer inquiries • Assist with special projects and serve as a resource for other payor authorization teams • Perform other assigned duties

🎯 Requirements

• High School diploma or GED equivalent • One (1) year working knowledge of patient registration and insurance verification and authorization processes in a medical organization • Epic experience preferred • No licenses or certifications required • Must comply with Stanford Health Care's C-I-CARE patient-experience standards

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