[Hiring] Financial Clearance Analyst @Yale New Haven Health

Role Description

The Financial Clearance Analyst is responsible for the financial clearance of complex patient authorizations, including:

• Insurance verification
• Price estimation
• Validation of medical necessity for services

In addition, the analyst is accountable for coordinating the activities of the patient account from the point of scheduling through account clearance. Responsibilities include:

• Formulating solutions to respond and resolve non-clinical customer requests, issues, and problems
• Meeting the changing demands and priorities in a hospital environment
• Working closely with patients, families, outside departments, and third-party payers to ensure compliance with all authorization and medical necessity guidelines
• Protecting the patient and the Hospital from unnecessary financial loss

Qualifications

• High school graduate or GED required, with work in healthcare or business preferred
• Associate Degree preferred
• CRCS or equivalent certification for Access Professionals required or in process (within 18 months of hire)
• Two (2) to three (3) years of work experience with insurance authorization/verification of benefits, revenue cycle functions, hospital/physician offices, or related areas preferred
• CRCS or equivalent certification for Access Professionals required or in process (within 18 months of hire)
• Strong organizational skills and ability to prioritize tasks
• Strong interpersonal skills and ability to build rapport with a wide variety of individuals
• Knowledge of payer reimbursement processes and insurance terminology
• Basic understanding of diagnostic testing and procedure codes (CPT, HCPCS, ICD-9-CM/PCS, and ICD-10-CM/PCS coding, etc.)
• Excellent verbal and written communication skills including the ability to communicate with physician providers
• Intermediate working knowledge/understanding of medical terminology and disease process
• Expert knowledge of Microsoft Office, Word, and Excel

Requirements

• Collects, validates, and accurately documents patient insurance and benefits information
• Utilizes the On-line Eligibility system and/or other means (i.e. telephone, fax, or various third-party payer websites) to obtain insurance benefits
• Obtains prior authorizations from third-party payers in accordance with payer requirements
• Maintains a professional approach at all times when communicating with patients, co-workers, and payer representatives
• Enhances the overall patient care experience through efficient work processes and communication of delays
• Participates in ongoing quality improvement efforts of the department

Company Description