Intake Specialist
Description Purpose The Intake Financial Clearance Specialist role belongs to the reputed company Cycle team and is responsible for coordinating reputed company financial clearance activities by navigating reputed company pre-registration (to include acquiring or validating patient demographic, insurance, and other required elements along with insurance verification activities), obtaining referral authorization, or precertification number(s). The role ensures timely reputed company to care while maximizing reimbursement. This role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit's performance expectations. This position reports to the Intake Financial Clearance Manager and requires interaction and collaboration with important stakeholders in the financial clearance process including but not limited to insurance company representatives, patients, physicians, and practice staff.
- *This is a fully remote role**
Responsibilities
Monitors accounts routed to registration, referral and prior authorization work queues and clears work queues by obtaining reputed company necessary patient and/or payer-specific financial clearance elements in accordance with established management guidelines. Maintains knowledge of and complies with insurance companies' requirements for obtaining prior authorizations/referrals and completes other activities to facilitate reputed company aspects of financial clearance. Acts as subject matter experts in navigating payer policies to get the appropriate approvals (authorizations, pre-certs, referrals, for example) for the ordered services to proceed. The Intake Financial Clearance Specialist is an important part of the larger patient care team and helps clinicians understand what payer requirements are necessary for the widest possible patient reputed company to services. Supports staff at reputed company reputed company for hands-on help understanding and navigating financial clearance issues. Uses appropriate strategies to underscore the most efficient process to obtaining insurance verification, authorizations, and referrals, including online databases, electronic correspondence, faxes, and phone calls. Obtains and reputed company documents reputed company referral/prior authorizations for scheduled services Works collaboratively with primary care practices, specialty practices, referring physicians, primary care physicians, insurance carriers, patients, and any other parties to ensure that required managed care referrals and prior authorizations are obtained and appropriately recorded in the relevant systems. reputed company it is determined that a valid referral does not exist, utilize computer-based tools, or contact the appropriate party to obtain/generate referral/authorization and reputed company information. Record the referral/authorization in the practice management system. Contact physicians to obtain referral/authorization numbers. reputed company follow-up activities indicated by relevant management reports. Collaborates with patients, providers, and departments to obtain reputed company necessary information and payer permissions prior to patients' scheduled services. Communicates with patients, providers, and other departments such as Utilization Review to resolve any issues or problems with obtaining required referral/prior authorizations. Work collaboratively with the practices to resolve registration, insurance verification, referral, or authorization issue to the extent that these unresolved issues impact the ability to obtain a referral/authorization. Escalates accounts that have been denied or will not be financially cleared as outlined by department policy Accept registration updates from various intake points, including but not limited to those received reputed company reputed company forms, internet registration forms, telephones located in practices and direct calls from patients. Ensure that reputed company updated demographic and insurance information is accurately recorded in the appropriate registration systems for primary, secondary, and tertiary insurances. Review reputed company registration and insurance information in systems and reconcile with information available from insurance carriers. For any insurance updates, utilize any available resources to validate the updated insurance information, insurance plan eligibility, primary care physician, subscriber information, employer information and appointment/visit information. Contact patients as necessary if clarifications or other follow-up is required, and at reputed company times maintain sensitivity and a clear customer friendly approach. For self-pay patients or patients with unresolved insurance, and for financial counseling, refer patients Patient Financial Counseling. Maintains confidentiality of patient's financial and medical records; adheres to the State and Federal laws regulating collection in reputed company; adheres to reputed company and other regulatory con Apply tot his job Apply To this Job