Financial Clearance Specialist

Employment Type:

Full time

Shift:

Day Shift Description:

Purpose Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization's strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge.

Note:

"patients" refers to patients, clients, residents, participants, customers, members The schedule for this position is: Monday - Friday 7:30 am - 4 pm, onsite. Minimum Qualifications is a

MUST:

High School Diploma or equivalent. Two (2) to Five (5) years experience in area of expertise such as scheduling, financial clearance, or patient access. National certification in HFMA CRCR or

NAHAM CHAA

required within one (1) year of hire. Must be proficient in the use of Patient Registration/Patient Accounting systems and related software systems.

Essential Functions Our Trinity Health Culture:

Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions.

Work Focus:

Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience. Responsible for distribution of analytical reports.

Process Focus:

Utilizes multiple system applications to perform analysis, create reports & develop educational materials. Incorporates basic knowledge of Trinity Health policies, practices & processes to ensure quality, confidentiality & safety are prioritized. Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge.

Data Management & Analysis:

Research & compiles information to support ad-hoc operational projects & initiatives. Synthesizes & analyzes data & provides detailed summaries including graphical data presentations illustrating trends & recommending practical options or solutions while considering the impact on business strategy & supporting leadership decision making. Leverages program & operational data & measurements to define & demonstrate progress, ROI & impacts. Maintains a Working Knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices. Functional Role (not inclusive of titles or advancement career progression Specialist I Must possess a comprehensive knowledge of financial clearance and insurance verification processes with two (2) years of financial clearance experience in an acute care setting. Responsible for all pre-service account's financial clearance and collection prior to the date of service Obtains and verifies accurate insurance information, benefit validation, authorization, and preservice collections. Begins the overall patient experience and initiates the billing process for any services provided by the hospital. Specialist II Experienced in processing financial clearance for complex services including surgical services, observation, and in-house cases. Minimum of five (5) years of financial clearance / authorization experience in an acute care setting. Experienced in complex facility based ancillary testing across multiple facilities/states. Responsible for complex, high-dollar services including surgical, observation and in-house services working in multiple areas of verification including outpatient verification, elective short procedure / inpatient verification, & urgent admission verification or scheduling. Additional Qualifications (nice to have) Associates Degree, preferred. Comprehensive knowledge of scheduling with mastery in at least three (3) or more modalities and insurance verification processes with three (3) years scheduling experience in an acute care setting Experience in complex facility based ancillary testing across multiple facilities/states Strong knowledge of third-party and government payer billing and reimbursement guidelines as well as department performance standards and policies and procedures. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law. Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. Together, we're 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, our system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations, and many other health and well-being services. Based in Livonia, Michigan, in fiscal year 2023, we invested $1.5 billion in our communities through charity care and other community benefit programs. For more information, visit http://www.trinity-health.org. You can also follow Trinity Health on LinkedIn.