Patient Financial Clearance Representative

🔥 15 hours ago

🏈 Alabama, Florida, +13 more states – Remote

🏈 Alabama – Remote 🐊 Florida – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🦀 Maryland – Remote 🚗 Michigan – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote

💵 $17 - $26 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

💸 Financial Planning and Analysis (FP&A)

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 1%

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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VCU Health

WebsiteLinkedInAll Job Openings

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 • Verify insurance eligibility and health plan benefits using multiple systems, web-based tools, and calls to payers and patients • Procure PCP referrals and health plan authorizations • Calculate out-of-pocket liability and collect deposits, co-pays, deductibles, and outstanding balances before service • Communicate patient financial responsibility clearly and transparently • Restrict or redirect out-of-network patients • Refer patients to financial counselors when assistance is needed with alternate payer sources or payment plans • Contact primary care physicians to secure PCP referrals • Contact health plans to secure prior authorizations • 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 • Maintain knowledge of commercial, managed care, governmental health care plans, and authorization/referral requirements

🎯 Requirements

• Minimum three (3) years of previous experience in a health care setting • Experience in commercial, managed care and governmental health insurance plans • One (1) year experience in insurance plan authorization and referral requirements; or Medical billing • Previous experience using a personal computer and various software applications, including Microsoft, e-mail, etc. • Strong customer service skills and patient/customer-centered focus • High School Diploma or equivalent • No licensure, certification, or registration required for hire or continued employment • May require work hours to periodically extend to 8:00 p.m. as necessary to resolve backlog or contact patients for registration data • Ability to lift 20–50 lbs. • Ability to perform prolonged sitting, reaching, repetitive motion, and prolonged PC/keyboard usage • Strong recall, reasoning, problem solving, hearing, clear speech, legible writing, reading, logical thinking, and concentration/focus • Ability to work in a fast-paced environment, handle multiple priorities, frequent and intense customer interactions, noisy environments, and frequent change • Previous experience using GE-IDX Patient Registration or another medical billing/registration system preferred • Previous experience in ICD and CPT coding preferred • Previous experience using medical terminology preferred • Post high school education in healthcare or medical billing coursework preferred

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