Financial Clearance Center Specialist

Adoration Health

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.

• 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 Healths Compliance Program by adhering to policies and procedures pertaining to HIPAA FCRA and other laws applicable to BrightSpring Healths business practices.
• Completes all required training maintains active working knowledge of BrightSpring healths 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.

• 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