Our Company
Adoration Health
Overview
The Financial Clearance Center (FCC) Specialist contacts insurance companies, branch operations, and patients to ensure accurate patient demographic and insurance information including insurance verification/benefits/authorizations, and the status of a used/remaining benefits.
Prefer candidate be in Jackson Mississippi, remote available.
Responsibilities
- Verifies eligibility and insurance benefits including but not limited to: Confirming the status of used/remaining benefits using electronic and telephonic resources, communicating, and identified insurance plan to billing manager for system updates.
- Obtains pre-certification, authorizations, and referrals to ensure managed care compliance for necessary services.
- Fulfills notification requirements.
- Partners and maintains working relationship with various departments throughout the organization, including Business HUB, Clinical Coordinators and Branch Operations
- Provides patient education as needed on various topics including patient rights, regulatory requirements, and financial policies.
- Prepares oral/written communications including periodic status updates.
- Maintains documentation and notes in computer system regarding all conversations with patients, insurance company representatives, and pre-certification.
- Supports BrightSpring Health's Compliance Program by adhering to policies and procedures pertaining to HIPAA, FCRA, and other laws applicable to BrightSpring Health's business practices.
- Completes all required training, maintains active working knowledge of BrightSpring health's Code of ethics (LEGACY), and immediately follows reporting procedures related to compliance, incidents, HIPAA, and adheres to confidentiality obligations.
- Maintains effective communication strategies and style with patients, insurance companies both verbally and in writing to ensure a positive overall internal/external customer service experience.
Qualifications
- HR Diploma/GED required; Preferred Associates Degree or BS/BA from accredited college.
- 2+ years of experience in a role that interfaces with commercial or government insurance payers to verify medical coverage or to perform billing, collections or follow up activities on covered charges for patients
- Medical billing certificate/ medical insurance specialty certificate preferred
- Strong analytical skills to process admissions and accurately and timely
- Demonstrated ability to navigate Web Based programs and Microsoft Office/including Excel
- Demonstrated ability to communicate effectively and to simplify complex information to all stakeholders in verbal and written form
- Ability and willingness to work cohesively in a team environment locally and across other departments and locations
- Demonstrate patience with a strong attention to detail
- Demonstrated ability to apply critical thinking skills, creativity, and a commitment to ensure that we meet the needs of stakeholders and patients.
- Minimal travel, rarely or as needed
About our Line of Business
Adoration Health, an affiliate of BrightSpring Health Services, provides quality and compassionate services in the comfort of home, providing support for patients, families, and caregivers in their time of need. Adoration was formed to fill the need for a loving, community-focused, caring organization. We empower patients to live with dignity, find a sense of fulfillment, and celebrate with their families a life well-lived. Our employees and caregivers are proud to be a part of the Adoration team and the mission of our company. For more information, please visit www.adorationhealth.com. Follow us on Facebook and LinkedIn.