UR Financial Clearance Specialist

At Nebraska Methodist Health System, we focus on providing exceptional care to the communities we serve and people we employ. We call it The Meaning of Care – a culture that has and will continue to set us apart. It’s helping families grow by making each delivery special, conveying a difficult diagnosis with a compassionate touch, going above and beyond for a patient’s needs, or giving a high five when a patient beats a disease or conquers a personal health challenge.

We offer competitive pay, excellent benefits and a great work environment where all employees are valued! Most importantly, our employees are part of a team that makes a real difference in the communities we live and work in.
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* Job Summary:

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* Location:

Methodist Hospital  Address: 8303 Dodge St.

- Omaha, NE

Work Schedule:

Mon - Fri, business hours; every 5th Saturday    Responsible for submitting insurance notification to insurers based on established requirements in a timely and accurate manner. Assist with verification and authorization for payment of hospital services.
** Responsibilities:
**** Essential Job Functions
** Complete notification of patient admission following payer specific guidelines.
* Use websites for notification when available.
* Collect contact information for clinical review in electronic health record.
* Provides diagnosis and demographic information as requested by payers.
* Complete telephonic notification and online notification for failed UHC 278 transfers.

Ensure all payer sources (commercial and governmental) are verified as eligible.
* Complete verification process for all patient insurance if not complete.
* Investigate and correct all application alerts.
* Ensure payment order for payers is correct.
* Confirm payer order is correct.

Prioritize notifications.
* Use daily census to ensure all cases requiring notification are completed within 24 hours of admission.
* Prioritizes notification of payers, using available contact methods.
* Monitor reports to identify patients with change of status requiring notification.

Utilize online systems to complete notification and precertification.

Communication.
* Document complete and accurate information in Case Management software using established abbreviations.
* Communicate directly with UR nurse unique or unusual notification requirements.

Update insurance reference guide regularly based on changes in payer requirements.

Deliver required notification documents to patients in a timely manner based on payer requirements.

Adhere to safety and Infection Control guidelines.
* Reports unsafe conditions or accidents immediately.
* Maintain a safe working environment.
* Follow established guidelines for contact with patients in isolation.
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* Schedule:

** Mon - Fri, business hours; every 5th Saturday
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* Job Description:

**** Job Requirements
**** Education
* ** Associates degree in a health care related field required.
* Healthcare/ insurance experience may be considered in lieu of educational requirement.
** Experience
* ** Minimum six months of insurance notification and/or authorization experience preferred.
* Experience with online payer notification programs preferred.
** License/Certifications
*** N/A
** Skills/Knowledge/Abilities
*** Skill with written and verbal communication.
* Skill working effectively with other employees, patients and external parties.
* Skill using Microsoft Office Suite and other specialized programs.
* Knowledge of medical terminology.
* Ability to organize, perform and track multiple tasks accurately.
* Ability to complete work accurately and within established time frames.
* Ability to work independently and in a team.
* Ability to adapt to changing priorities.
** Physical Requirements
**** Weight Demands
*** Light Work - Exerting up to 20 pounds of force.
** Physical Activity
*** Not necessary for the position (0%):  + Climbing  + Crawling  + Kneeling
* Occasionally Performed (1%-33%):  + Balancing  + Carrying  + Crouching  + Distinguish colors  + Lifting  + Pulling/Pushing  + Standing  + Stooping/bending  + Twisting  + Walking
* Frequently Performed (34%-66%):  + Grasping  + Reaching  + Repetitive Motions
* Constantly Performed (67%-100%):  + Fingering/Touching  + Hearing  +…