Jr Financial Clearance Analyst
Company: Cape Cod Healthcare Inc.
Posted on: November 25, 2022
- Troubleshoot and evaluate work product of staff, make
recommendations to management and assists with implementing
- Participate with management in strategizing for Process
Improvement initiatives to improve cash flow.
- Attend and participate in management meetings.
- Assists management on special organizational projects for
- Provide input and feedback for employee evaluations.
- Work collaboratively with Patient Access Managers, Scheduling
Managers, Business Office Managers, Vendors and Customers across
the enterprise to ensure that Registrars and Schedulers are fully
capable of using technology to properly register our patients.
- Assists with review of financial clearance and registration
procedures and ensure effective communication with physician
practices, patients and internal departments.
- Work with department managers to continuously identify and
correct issues identified by reporting.
- Assist Patient Access Managers with Quality Control assessments
of their staff related to eligibility and pre-registration
- Verifying insurance eligibility using available technologies,
payer websites, or by phone contact with third party payers.
Working in accordance with required State and Federal regulations
and CCHC policies.
- Contact patients as needed to gather demographic and insurance
information, and updates patient information within the EMR as
- Ensure correct insurance company name, address, plan, and
filing order are recorded in the patient accounting system.
- Processes outgoing referrals to specialists outlined by the
patient's insurance plans in a timely manner.
- Utilize payer websites and/or Epic/Experian to process, obtain
and verify insurance referrals.
- Utilizing the incoming referral work queue will request, obtain
and link insurance referral authorizations to upcoming specialty
appointments as outlined by the patient's insurance plan in a
- Track, document and communicate the status of referrals as they
move through the referral process, ensuring proper follow-up,
documentation and communication when the referral has been
- Maintain core competency and current knowledge of regulatory
payer authorization and eligibility requirements.
- Obtain and verify authorizations to ensure payment for services
provide through CCHC.
- Work accounts in assigned work queues to resolve billing errors
and edits to ensure all claims are filed in a timely manner.
- Follow-up and work registration/authorization claim denial work
queues to identify and take the appropriate action to fix errors
for claim resubmission to payers.
- Maintain close coordination with Practice Managers,
Clinical/Front End staff, and Physicians to advise of any changes
or updates to insurance payer requirements.
- Responds to all practice inquiries and questions about
insurances, referrals, and authorizations.
- Meets and maintains daily productivity and quality standards
established in departmental policies.
- Assists the department, work unit and/or fellow staff members
by cross-covering for absences, participating in special projects,
and attending ongoing training sessions, etc.
- Attends and participates in educational programs, in-service
meetings, workshops, and other activities as related to job
knowledge and state guidelines.
- Ability to work with minimum supervision and in a team
- Performs other job-related duties and assignments as
- Demonstrates the ability to adjust to unexpected changes to
assure all responsibilities/duties are met during absences or
increases in work volume.
- Associate Degree strongly preferred, High School diploma or GED
- Minimum of one (1) year experience in a large hospital's
Revenue Cycle Department with an emphasis on Patient Access and or
Scheduling is strongly desired.
- Experience with large hospital information systems is required,
preferably Epic and/or Siemens is preferred.
- Excellent interpersonal, problem solving and critical thinking
- Excellent PC skills with a strong emphasis on the Outlook suite
- Excellent verbal and written communication skills are
- Medical Terminology knowledge preferred
- Experience utilizing insurance payer websites
Keywords: Cape Cod Healthcare Inc., Plymouth , Jr Financial Clearance Analyst, Accounting, Auditing , Plymouth, Massachusetts
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