Patient Financial Clearance Representative I

🔥 1 hour ago

🇺🇸 United States – Remote

💵 $34 - $38 / hour

⏰ Full Time

🟢 Junior

💸 Financial Planning and Analysis (FP&A)

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Stanford Health Care

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1991

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • Healthcare Insurance • Pharmaceuticals

Stanford Health Care is a leading healthcare provider affiliated with Stanford University, offering a wide range of medical services, including primary, specialty, and emergency care. Known for its cutting-edge research and innovation in medicine, the facility also partners with Stanford Medicine and Stanford School of Medicine to provide top-tier medical education and research opportunities. Patient care is enhanced through their MyHealth online and mobile platforms, allowing easy access to medical records, appointment scheduling, and bill payments. Stanford Health Care is dedicated to improving health outcomes through advanced technology, personalized care, and comprehensive health services.

📋 Description

• Complete insurance verification, eligibility, and benefit determination using electronic eligibility systems, payer websites, and phone • Interpret and document co-pays, deductibles, 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 assigned payors and work queues • Develop knowledge of procedures and diagnoses used in assigned service lines to complete authorizations • Assess required data and communicate with clinics and referring providers to secure authorization information • Follow up on pending authorization and referral requests • Arrange peer-to-peer appeal reviews with payor utilization management when needed • Prioritize work to minimize financial risk, complete authorizations timely, and meet productivity goals • Identify and escalate coverage, benefit, and financial-clearance risks • Refer cases to financial counseling when appropriate • Notify management of errors or obstacles • Document accounts and prepare email communications and internal notes/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

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