Financial Clearance Coordinator

The Financial Clearance Coordinator manages assigned high-risk insurance accounts within the Finance department. Verifies insurance benefits, obtains authorizations and pre-certifications, performs notice of admissions, and updates cost estimates prior to outpatient visits or scheduled admissions. Serves as a liaison between the family, provider, and insurance company to ensure financial clearance of assigned accounts.

Additional Information
Department Name: RAVE/Insurance Verifications
Job Status: Full time, 40 hours per week.
Shift: Day 8am to 5pm, Hybrid

Duties & Responsibilities

Population Specific Care:
* No direct patient care.
ESSENTIAL FUNCTIONS
An employee in this position may be called upon to do any or all of the following essential functions. These examples do not include all the functions the employee may be expected to perform.

1. Ensures accounts are secured and complete by performing benefit verification, estimate finalization, notice of admission, and/or prior authorization for services. Notifies insurance companies of expected services rendered and secures authorization/pre-certification as per payer requirements.
2. Ensures patients are informed of benefits and associated costs by creating and communicating personalized estimates of financial responsibility.
3. Verifies that all required referrals are in place for services to be covered by the payor and verifies policy details including any exclusions the payor may have for expected services rendered.
4. Addresses referral/authorization issues by coordinating with families, clinics, and referring providers to ensure financial security of encounters.
5. Verifies, updates, and edits insurance coverage information for patients.
6. Identifies and resolves issues related to insurance information, referrals, and authorizations promptly.
7. Utilizes payer portals, automation, and relevant systems to secure financial aspects of accounts.
8. Participates in peer development programs and serve as a resource for co-workers and staff.
9. Adheres to HIPAA regulations and appropriately document all contacts within PHI-secured systems.
10. Provides customer service in person, by phone, or email; assists patients, families, providers, and staff with insurance or cost estimate-related inquiries and escalations, and self-pay estimates for those without coverage or for non-covered services. Responds to inquiries about anticipated costs, calculate balances based on coverage and benefits, coordinate with clinics and families.
11. Assists in payment collection before services are rendered by utilizing the cost estimate tool to ensure financial security of the organization.
12. Navigates hospital account records to identify billed services and identifies how insurance coverage was applied. Resolves errors within accounts regarding eligibility, verification, and authorization to ensure clean claims.
13. Collaborates with various departments throughout the organization to ensure accounts are secured prior to date-of-service.
14. Adheres to departmental guidelines for various expectations including productivity, quality, and prioritization of workload.

Minimum Qualifications

• Degrees
  • High School Diploma or Equivalent
    
    
• Experience
  • One (1) year of customer service experience
    

Salary Information
Pay is dependent on applicant's relevant experience.

Hourly Range: $18.26 to $27.40

Benefits Information
Here, you matter. As a Children's Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development tools, including an education benefit to help you advance your career.

As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April.

Children's Colorado delivers annual base pay increases to eligible team members based on their performance over the previous year.

EEO Statement
It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information. The position is expected to stay open until the posted close date. Please submit your application as soon as possible as the posting is subject to close at any time once a sufficient pool of qualified applicants is obtained.

Colorado Residents: In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of attendance at or graduation from an educational institution. You will not be penalized for redacting or removing this information.