Financial Clearance Representative Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: pride in what we do, knowing every moment matters here. We invite you to become part of Connecticuts most comprehensive healthcare network. The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.
Position Summary:
HHC completes a systematic review of scheduled appointments for required elements that must be secured to achieve financial reimbursement. We also create an opportunity to strengthen the financial relationship with our consumers by providing pricing transparency and assisting them prior to service with understanding, navigating and fulfilling their consumer responsibilities. This position encourages and represents HHCs mission in working towards responding to the needs of our communities and our patients. The Financial Clearance Representatives role is to review accounts via work queues; verify payer information, review payer filing order, initiate and document payer authorization information, complete notification of admission and discharge within established payer requirements, provide cost of care estimates and collection of patient cost share with a focus on claim denial prevention by collaborating with clinical teams, business partners and insurance payers.
Position Responsibilities:- Validate accuracy of payer information; document payer source data
- Compile financial data required to verify accuracy of clients fee source/method of payment to assure timely reimbursement
- Prepare a price estimate and communicate the uninsured or out-of-pocket expenses including co-pays, deductibles, and co-insurance to consumers
- Initiate process of insurance verification for all payers
- Contact insurance companies to investigate coverage and obtain pre-authorization/authorization for emergent admissions and other scheduled services within scope
- Document detailed pertinent information related to authorization activity while meeting established requirements in an effort to facilitate payer follow up and support denial dispute
- True to HHC Mission and Values, demonstrate positive and effective relationships across the continuum and support a coordinated care experience including timely and accurate communication with internal and external business partners
- Collaborate and communicate with transitional care staff, clinical colleagues, medical offices and business partners
- Adherence to the practice of confidentiality, HIPAA and other state/federal regulations. Ensure compliance with regulatory and agency policies and procedures
Demonstrate H3W Leadership behaviors and supports culture and team building initiatives.
Skills/Desired Attributes:
Positive outlook
Excellent oral and written communication skills; self-directed, with a spirit of team support and success
FlexibleDetail oriented
Computer literacy including Microsoft Office and Excel
Experience and interest in problem resolution and process improvement; Creative thinker; Analytical skillsEPIC experience a plus
Basic medical terminology
Ability to perform in a production environment with a high-quality output of work
Able to sit for 90% of the day
Qualifications
Education: High School Diploma or GED is required, Associates Degree preferred
