Financial Clearance Rep bei SBH Health System

Under general supervision and in accordance with established policies and procedures, the Financial Clearance Representative is responsible for coordinating the insurance clearance process by completing financial clearance for both inpatient and outpatient visits, including scheduled and non-scheduled appointments.  Cases needing financial clearance may include (but not limited to) inpatient admissions, outpatient diagnostic testing, inpatient/outpatient surgery, pathology and lab work verification, clinical trial research, identification of coverage for discharge planning purposes and/or follow-up visits.  The representative serves as a liaison between the patient, referring physician, Care Transitions and insurance plans to ensure that all services are financially cleared in advance of the service date through discharge.  

The Financial Clearance Representative will be responsible for (but not limited to) verifying eligibility, benefits, referral and authorization requirements in addition to obtaining referrals and authorizations as necessary.  In addition, the Financial Clearance Representative will be responsible for the financial work-up for self-pay (uninsured) patients, including obtaining the necessary patient information for Medicaid, submission of applications and follow-up.  Each representative will assist walk-in patients and provide information of payment options (Medicaid, Charity Care and payment plans) to uninsured patients.