[Hiring] Financial Clearance Specialist @Yale New Haven Health

Role Description

The Financial Clearance Specialist is responsible for ensuring that payers are prepared to reimburse Corporate Business Services (CBS) for scheduled services in accordance with the payer-provider contract. Responsibilities include:

• Financial clearance of transplant, surgical, chemotherapy, and radiation therapy patients.
• Insurance verification, price estimation, and validation of medical necessity for certain services.
• Maintaining a proficient understanding of third-party payer regulations and guidelines.
• Determining benefit and coverage levels and connecting patients with financial assistance resources.
• Striving for the highest level of customer service in all encounters with patients and families.

Qualifications

• High school graduate or GED required; work in healthcare or business preferred.
• Bachelor's Degree preferred.
• CPC, LPN, Pharmacology License or other medical degree or equivalent preferred.
• CRCS or equivalent certification for Access Professionals required within 18 months of hire.
• Certified Medical Assistant (CMS), Licensed Practical Nurse (LPN), or Certified Professional Coder (CPC) status preferred.

Requirements

• Three (3) to four (4) years of work experience with insurance authorization/verification of benefits, revenue cycle functions, hospital/physician offices, or related areas preferred.
• Strong organizational skills and ability to prioritize tasks.
• Excellent verbal and written communication skills.
• Strong interpersonal skills and ability to build rapport with a wide variety of individuals.
• Advanced working knowledge of code sets required.
• Basic understanding of diagnostic testing and procedure codes (CPT, HCPCS, ICD-9-CM/PCS, and ICD-10-CM/PCS coding, etc.).
• Attention to detail and ability to multitask.
• Advanced knowledge of Microsoft Office, Word, and Excel.

Company Description