Financial Clearance Specialist Associate; Pennsylvania resident

Overview

Provides seamless pre-registration for scheduled ambulatory appointments and hospital scheduled admissions. Performs insurance verification, documents out-of-pocket expenses, and acquires necessary referrals. Reviews insurance benefits with patients and attempts to collect copays, deductibles, coinsurance, outstanding balances, and pre-service payments to contribute to department point-of-service collections.

• Maintain HIPAA-compliant, accurate pre-registration while contacting patients by phone to verify demographics and insurance information.
• Discuss out-of-pocket expenses, outstanding balances, and pre-service payments with patients and attempt to collect on these services.
• Transfer patients to Department Financial Counselors if payment options are requested.
• Perform insurance verification for various payers using automated systems (Passport) and manual processes to ensure accurate insurance information in the electronic medical record.
• For insurances not processed automatically, place calls to insurance carriers to obtain eligibility and out-of-pocket estimates.
• Review and select the appropriate insurance and visit indicator to ensure correct billing for cadence appointments.
• For hospital scheduled admissions, prioritize the correct coverage and list it on the HAR to ensure correct insurances are billed.
• Review or request referrals for future appointments by sending telephone encounters to Geisinger Primary Care Providers (PCP) and contacting outside PCP offices by fax to request referrals.
• Complete Medicare Secondary Payer Questionnaire for applicable patients.
• Enter Financial Comments and Financial Clearance indicators in the appointment information tab in the software system, using financial abbreviations to advise staff what has been completed.
• Document demographics status, insurance verification, referrals, and any forms requiring patient signatures.
• Utilize department-established codes for documenting the process.
• For hospital scheduled admissions, complete documentation in the authorization and certification tab.
• Notify supervisor of unusual circumstances or issues for resolution.
• Explain and obtain signatures for forms required at patient arrival, such as Assignment of Benefits (AOB), Universal Auth (UA), Privacy Acknowledgment (PACK), and Notice of Financial Responsibility (NOFR).
• Meet productivity, quality, and Point of Service (POS) collection goals.
• Function as a team member to organize and prioritize work queues; assist coworkers to complete work within department time frames.
• Suggest improvements to procedures or innovations to heighten the patient experience.

High School Diploma or Equivalent (GED) - Required

Minimum of 1 year - Related work experience (Required)

Not specified in provided description

OUR PURPOSE & VALUES:
Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS:
We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE:
We treasure colleagues who humbly strive for excellence. LEARNING:
We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION:
We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY:
We provide a safe environment for our patients and members and the Geisinger family.

We offer healthcare benefits for full-time and part-time positions from day one, including vision, dental, and domestic partners. We encourage collaboration and collegiality, and value a diverse workforce to improve health outcomes for all. We are proud to be an affirmative action, equal opportunity employer; all qualified applicants will receive consideration regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.