Financial Clearance Representative Associate - Pharmacy Prior Auth
Accounting & Finance
Minneapolis, MN, USA
Posted on Thursday, February 8, 2024
Number of Job Openings Available:1
Date Posted:February 07, 2024
Department:16008901 Revenue Cycle Management Courage Kenny Rehabilitation Institute Scheduler Regular
Shift:Day (United States of America)
Shift Length:8 hour shift
Hours Per Week:40
Job Summary:Responsible for completing the financial clearance process and creating the first impression of Allina’s services to patients, their families and other external customers. Articulates information in a manner that patients, guarantors, and family members understand and will know what to expect regarding their financial responsibilities. Works with medical staff, nursing, ancillary departments, insurance payers, and other external sources to assist families in obtaining healthcare and financial services.
Key Position Details:
- Full time, day shift position
- Benefit eligible
Job Description:Principle Responsibilities
- Perform daily Financial Clearance activities.
- Perform financial clearance processes by interviewing patients and collecting and recording all necessary information for pre-registration of patients
- Educate patients of pertinent policies as necessary i.e., Patient Rights, HIPAA information, consents for treatment, visiting hours, etc.
- Verify insurance eligibility and completes automated insurance eligibility verification, when applicable and appropriately documents information in Epic
- Confirm that a patient’s health insurance(s) is active and covers the patient’s procedure
- Confirm what benefits of a patient’s upcoming visit/stay are covered by the patient’s insurance(s) including exact coverage, effective date of the policy, coverage limitations / requirements, and patient liabilities for the type of service(s) provided
- Provide proactive price estimates and works with patients so they understand their financial responsibilities
- Inform families with inadequate insurance coverage of financial assistance through government and financial assistance programs and refers the patient to financial counseling
- Review and analyzes patient visit information to determine whether authorization is needed and understands payor specific criteria to appropriately secure authorization and clear the account prior to service where possible
- Ensure that initial and all subsequent authorizations are obtained in a timely manner
- May provide mentoring to less experienced team members on all aspects of the revenue cycle, payer issues, policy issues, or anything that impacts their role
- Other duties as assigned.
- Must be 18 years of age with education and/or experience needed to meet required functional competencies as listed on the job description, and High school diploma or GED preferred
- Associate's or Vocational degree in Business Administration, Health Care Administration, Public Health, or Related Field of Study preferred
- 0 to 2 years experience with Insurance and Benefit Verification, Pre-Registration and/or Prior Authorization activities in healthcare business office/insurance operations required
- 0 to 2 years Experience working with clinical staff. Previous experience working in outpatient and/or inpatient healthcare settings preferred
- 0 to 2 years Experience working with clinical documentation. Previous experience working with a patients clinical medical record preferred
Lifting weight Up to 10 lbs. occasionally, negligible weight frequently