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Financial Clearance Specialist III

ICONMA, LLC

Irwindale, CA

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JOB DETAILS
SALARY
$15.23–$27.29 Per Hour
SKILLS
Analysis Skills, Avaya Software, Calendar Management, Cancer, Candidate Screening, Case Management, Co-Payments, Communication Skills, Continuous Improvement, Customer Relationship Management (CRM), Customer Support/Service, Data Entry, Demographics, Electronic Medical Records, Epic Systems, Fax Machines, Financial Liability, Financial Management, Financial Planning, Financial Services, Health Plan, Healthcare, High School Diploma, Identify Issues, Infection Control, Informed Consent, Insurance, Insurance Documentation, Interpersonal Skills, Managed Care, Medical Office, Medical Record System, Medical Records, Medical Terminology, Medical Treatment, Microsoft Outlook, Microsoft Word, Multilingual, Oncology, Organizational Skills, Outpatient Care, Patient Care, Patient Care Authorizations, Patient Education, Patient Registration, Policy Development, Presentation/Verbal Skills, Pricing, Problem Solving Skills, Procedure Development, Purchasing/Procurement, Quality Assurance, Record Keeping, Records Management, Safety/Work Safety, Salesforce.com, Service Delivery, Standards of Care, Team Player, Telecommunications, Telephone Skills, Telephone Technology, Utilization Management, Writing Skills
LOCATION
Irwindale, CA
POSTED
5 days ago
Our Client, a Cancer Center company, is looking for a Financial Clearance Specialist III for their Irwindale, CA location.
 
Responsibilities:
  • Referral Coordination:
  • Identifies insurance companies requiring prior authorization for services and  obtains authorization.
  • Coordinates authorizations for procedures and testing  requested by providers for their managed care patient.
  • Reviews charts on  outpatients and reports to third party payors.
  • Retrieves chemo/surgery orders from chart, and requesting authorization through the insurance companies.
  • Prepares all forms required by third party payor for treatment authorization requests.
  • Work on all pending utilization review patients, and achieve authorization for the following day.
  • Getting emergent authorizations from walk-in patients.
  • Verifying with the insurance companies and documents what needs to  be pre-certified.
  • Educates patient of their insurance policy.
  • Composes letters and memoranda from  physician dictation, or verbal direction for submission to insurance companies to obtain authorization or appeal denials.
  • Maintains current records on managed  care patients.
  • Keeps Case Managers updated on all BMO and BMT patients.
  • Pre-Registration :
  • Performs pre-registration functions prior to the patient appointment (including, but not limited to: obtains and/or verifies demographic, clinical, financial,
  • insurance information, service eligibility, consent forms, and patient/guarantor information for pre-registered accounts).
  • Contacts patients, payers, or other departments to confirm and verify insurance  and demographic information.
  • Refers patients to financial counselors to resolve  insurance or payments issues.
  • Identifies and resolves issues by working with patients, payors, and/or other Client  departments and personnel in a single interaction with the patient.
  • Identifies  patients with “share of cost” or co-payments by performing pricing estimations,  and notifies patients of their expected patient liability and financial responsibility.
  • Collects patient/guarantor liabilities and refers patients who are  uninsured/underinsured to Financial Counselor for charity, financial assistance or governmental program screening and application processes.
  • Notifies Client contracting department of patients with a non-contracted insurance to prepare a Letter of Agreement (LOA) should patient to pursue services at CLIENT and informs patient of approval status.
  • Performs activities required to financial clearance for all patient types.
  • Frequent communications will occur with patients/family members/guarantors,  physicians/office staff, medical center and payors.
  • Customer Service:
  • Ensure a high level of customer service by greeting, being a resource to patients  and visitors.
  • Serve as a liaison between patients and support staff.
  • Develop effective relationships with colleague, physicians, providers, leaders and other employees across the organization.
  • Demonstrates genuine interest in helping our patients, providers and other employees by using excellent communication skills, being polite, friendly, patient and calm under pressure.
  • Managing multiple, changing priorities in an effective and organized manger, under stressful demand while maintaining exceptional service.
  • Maintain composure when dealing with difficult situations and responding professionally.
  • Independently recognize a high  priority situation, taking appropriate and immediate action.
  • Effectively  communicates with service delivery and other departments to resolve issues that  impact patient care and escalating issues that cannot be resolved in accordance with departmental guidelines.
  • Answering daily phone calls and pages from  doctors, patients, employees and insurance companies.
  • Quality Assurance:
  • Maintains appropriate level of productivity and accuracy for work performed based  on department standards.
  • Maintains thorough knowledge of policies, procedures, and standard work within the department in order to successfully performance  duties on a day-to-day basis.
  • Miscellaneous Duties:
  • Performs other departmental duties as assigned, such as answering and making phone calls, managing incoming/outgoing faxes, organizing and filing
  • departmental documents, inventorying supplies, data entry, etc.
  • Follows established Client and department policies, procedures, objectives, performance
  • improvement, attendance, safety, environmental, and infection control guidelines, including adherence to  the workplace Code of Conduct and Compliance Plan.
  • Practices a high level of integrity and honesty in maintaining confidentiality.
  • Performs other related duties as assigned or requested.
 
Requirements:
  • Minimum Education:
  • High School Diploma
  • Minimum Experience:
  • Three years related healthcare pre-registration/referral experience required.
  • Medical terminology and electronic medical record experience required.
  • Preferred Courses/Training: EPIC EMR
  • Preferred Experience:
  • At least two years front desk oncology practice experience registering  patients and scheduling appointments.
  • Skills/Abilities:
  • Ability to recognize and use medical terminology Excellent oral/written communication, interpersonal, collaborative, analytical and organizational skills.
  • Bilingual preferred.
  • Demonstrated ability to effectively use online systems.
  • Function with minimal supervision with high level of productivity Foster and promote a positive and professional image
  • Must be able to foster and maintain sound working relationships.
  • Independently motivated and driven to achieve high goals
  • Effective use of telecommunications and electronic medical record systems Seek continuous improvement in knowledge and skills  Demonstrates ability to manage multiple, changing priorities in an  effective and organized manner, under stressful demands while  maintaining exceptional service.
  • Demonstrated ability to maintain composure when confronted by difficult
  • situations and to respond professionally.
  • Maintains commitment to our extraordinary patient care standards and  guidelines Interpersonal/human relations skills.
  • Strong knowledge of PC, phone systems and technology.
  • Readily accepts work assignments and changes in a positive manner.
  • Skill in recognizing an emergency or high priority situation, taking  appropriate and immediate action.
  • Software:
  • Microsoft Word and Outlook
  • EMRs – Allscripts, Touchworks and EPIC
  • Telecommunications – Avaya phone system
  • Customer Relationship Management - Salesforce
 
Why Should You Apply?

About the Company

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ICONMA, LLC

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