Financial Clearance Specialist

Job Number 69519
Posted 2/3/2020
Account Northern Light Health Home Office
Department Patient Financial Services
Location |ME| Northern Light Health Home Office - Godfrey Dr., Orono, ME 04473
Schedule Regular Full-time
Shift Day
Hours 0800-1630
Job Details Job Summary
This position is responsible for financial clearance of patient balances for EMHS Patient Account Services in a Centralized Business Office environment. This position is responsible for the collections of patient balances in accordance with regulatory and state laws. This position requires a thorough understanding of the requirements of healthcare collection protocols. In addition, this position is held accountable to adhere to the policies, procedures, and applicable laws; including metrics related to productivity and quality. This position works closely with a team of Financial Clearance Specialists to research and take corrective action on patient balances to ensure an optimum revenue cycle workflow.

Education and Experience
•High school diploma or equivalent required; Associate's degree preferred.
•At least one year of healthcare customer service experience preferred.

Required Minimum Knowledge, Skills and Abilities
•Detailed knowledge of patient collection operations in a healthcare setting; multiple hospitals/physician practices preferred.
•Knowledge of the payer's explanation of benefits document, local assistance programs, and healthcare billing procedures preferred.
•Experience with EMHS patient accounting software is preferred.
•Must possess strong problem solving skills.
•Excellent professional communication skills; both oral and written.
•Ability to understand payer processing guidelines as well as state laws and regulations.
•Proficient with Microsoft business applications.
•Customer oriented.
•Demonstrated ability to work independently and collaboratively.

Essential Functions

•Actively participate in team huddles and meetings by way of sharing knowledge, requesting information, and recommending process improvements.

•Interview patients for Financial Assistance
•Provides excellent customer service via first call resolution as frequently as possible.
•Advocate for patients regarding complaints or billing issues within the established policies and procedures of the department.
•Ensure all functions related to customer service support the team goals and objectives as well as EMHS's financial performance objectives.
•Advises management of customer service issues which may require attention in a timely manner.

•Process Financial Assistance Applications as per protocol and policy
•Resolve assigned accounts in a timely and accurate manner, which maximizes reimbursement in compliance with the department's policy and procedures.
•Research and accurately resolve outstanding patient balances in accordance with all departmental and system policies and procedures.
•Meet or exceed the EMHS performance standards as it relates to quality and productivity.
•Problem solving with peers and leaders to address patient balance issues or changes that directly impact the accounts receivable.

•Investigate and convert accounts to any potential third party payer (i.e. COBRA, Marketplace)
•Screen for eligibility with an governmental payers
•Establish patient payment terms in accordance with internal policy guidelines.
•Accurately processing of payments via credit, debit or HAS/FSA
•Accurately schedule patient payment plans in accordance with internal policy guidelines.
•Ensure all functions related to customer service supports the team goals and objectives as well as EMHS's financial performance objectives.
•Thorough understanding of the department's key performance indicators.

•Maintain the knowledge of collection protocols, payer, regulatory policies and laws.
•Attend internal education sessions to enhance or gain new skills.

•Demonstrate departmental desire to provide community benefits by way of charitable events or contribution outside the four walls of the department.

Organizational Values
Passion: We demonstrate a passion for caring for others and the pursuit of service excellence in all that we do.
Integrity: We commit to the highest standards of behavior and doing the correct thing for the right reasons.
Partnership: Working together in collaboration and teamwork is more powerful than working alone.
Accountability: We take a responsible and disciplined approach to achieving our priorities and responding to an ever changing environment.
Innovation: We are capable of extraordinary creativity and are willing to explore new ideas to achieve our healthcare mission.
Respect: We respect the dignity, worth and rights of others.

Physical Demands
•Sedentary: Exerting up to 10 lbs. occasionally, sitting most of the time, and only brief periods of standing and walking.
•Requires the ability to travel to member organizations as needed

Note: the duties listed above reflect the majority of the essential duties of this job and does not, nor is it intended to, reflect all essential duties that may be required for an incumbent in this job to perform.

Equal Opportunity Employment
We are an equal opportunity, affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, disability status, gender, sexual orientation, ancestry, protected veteran status, national origin, genetic information or any other legally protected status.

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