Financial Clearance Associate II
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Job Description
Financial clearance associate securing pre-certification and medical necessity approvals for Piedmont Healthcare’s complex outpatient services. Coordinating with payers, physicians, and office staff.
Responsibilities:
- Contact insurance companies and other third party payers to determine pre-certification, pre-authorization and/or medical necessity requirements for complex outpatient hospital services and specialized procedures.
- Obtain pre-certification or pre-authorization prior to scheduled complex services.
- Liaise with physicians and physician office staff to obtain additional demographic, insurance, or clinical information.
- Notify payers of admittance when required.
Requirements:
- H.S. Diploma or General Education Degree (GED) Required
- Bachelor’s Degree from a recognized college or university Preferred
- Completion of medical coder training program Preferred
- 3 years exp in Rev Cycle or related exp in healthcare, with one of those years working specifically within Healthcare Revenue Cycle Required
- 4 years of previous related healthcare Revenue Cycle experience Preferred
- Prior Epic experience Preferred
- Clinical experience (i.e., medical assistant, surgical tech) Preferred
- Licenses and Certifications: None Required
- Certification with Healthcare Financial Management Association Preferred
- Certified Revenue Cycle Representative Preferred
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