Financial Clearance Representatives represents EvergreenHealth as welcoming officials to patients. Responsible for accurate pre-registration of scheduled patients in a manner that promotes EvergreenHealth's values and contributes towards an optimum experience for patients. Accountable for proper patient identification to ensure patient safety. Initiates the Patient Revenue Cycle for maximum and timely reimbursement with utilization of registration functions/systems.
Essential Job Functions:
1. Enters demographic and billing information into EvergreenHealth's system.
2. Performs pre-registration of patient prior to scheduled admission in accordance to the departments pre-registration procedures.
3. Demonstrates knowledge of insurance payers and the use of electronic systems for verification purposes.
4. Verifies insurance eligibility, obtains co-pay amounts, and medical/clinical authorization for care as needed.
5. Uses electronic systems and payer websites for verification of insurance, authorizations and referrals.
6. Responsible for working with physician's office to assure authorization is in place prior to scheduled service when required.
7. Provides inpatient notification based on payer requirements.
8. Collect copays based on departmental guidelines.
9. Follows EvergreenHealth's Financial Clearance Policy.
10. Obtains authorization or referral (as required) and enters into patients encounter.
11. Identifies the need for financial counseling and refers patient to the Financial Counselor.
• Must utilize one or more Cerner applications to deliver and track patient care and multiple system applications.
• Ability to be flexible and relate well with others in a professional manner.
• Detail oriented and organized.
• Strong communication skills to work effectively with patients, physicians and staff.
• Works independently to manage the work volume and disseminate status update to other team members as needed.
License, Certification, Education or Experience:
REQUIRED for the position:
• High School graduate or equivalent
• Excellent communication skills to effectively obtain information from patients, physicians, other clients.
• Ability to function independently, organizes work, multitasks, and establishes priorities.
• Numerical ability is required to discuss financial arrangements including deposit requirements.
DESIRED for the position:
• Vocational training or college degree in the healthcare setting.
• 1 year prior experience in a hospital or medical setting
• Working knowledge of insurances.
• Knowledge of medical terminology.
*This position is covered by a collective bargaining agreement between EvergreenHealth and the Service Employees International Union (SEIU) Healthcare.