UR Financial Clearance Specialist

Omaha, NE - USA

Monthly Salary: Not Disclosed

Posted on: 13 hours ago

Vacancies: 1 Vacancy

Job Summary

Why work for Nebraska Methodist Health System
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. Its helping families grow by making each delivery special conveying a difficult diagnosis with a compassionate touch going above and beyond for a patients 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.

Job Summary:

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.

Schedule:

Mon - Fri business hours; every 5th Saturday

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

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 timeframes.
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
- Keyboarding/typing
- Seeing/Visual
- Sitting
- Speaking/talking

Job Hazards

Not Related:
- Chemical agents (Toxic Corrosive Flammable Latex)
- Physical hazards (noise temperature lighting wet floors outdoors sharps) (more than ordinary office environment)
- Equipment/Machinery/Tools
- Explosives (pressurized gas)
- Electrical Shock/Static
- Radiation Alpha Beta and Gamma (particles such as X-ray CAT scan Gamma Knife etc.)
- Radiation Non-Ionizing (Ultraviolet visible light infrared and microwaves that causes injuries to tissue or thermal or photochemical means)
- Mechanical moving parts/vibrations
Rare (1-33%): - Biological agents (primary air born and blood born viruses) (Jobs with Patient contact) (BBF)

About Methodist:

Nebraska Methodist Health System is made up of four hospitals in Nebraska and southwest Iowa more than 30 clinic locations a nursing and allied health college and a medical supply distributorship and central laundry facility. From the day Methodist Hospital was chartered in 1891 service to our communities has been a top priority. Financial assistance health education outreach to our diverse communities and populations and other community benefit activities have always been central to our mission.

Nebraska Methodist Health System is an Affirmative Action/Equal Opportunity Employer and does not discriminate on the basis of race color religion sex age national origin disability veteran status sexual orientation gender identity or any other classification protected by Federal state or local law.

Required Experience:

Why work for Nebraska Methodist Health SystemAt 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. Its helping families grow by making each del...