Financial Clearance Specialist

Accountabilities: Verify insurance eligibility, benefits, patient liability, and coverage requirements to support accurate financial clearance and minimize denials or penalties. Confirm benefits with insurance companies and employers, validate demographic information, and document insurance and payment details accurately. Review Medicare accounts and coordinate benefit status as needed. Identify and process pre-certification and referral requirements according to established protocols. Communicate with providers regarding out-of-network barriers and ensure relevant information is documented. Estimate patient financial responsibility before services and collect co-pays and other balances in accordance with cash-management policies. Review and resolve accounts placed on hold to support timely and accurate billing. Collaborate with authorization teams to obtain required payer authorizations and referrals. Maintain current knowledge of insurance plans, payer requirements, reimbursement practices, and regulatory changes. Ensure all activities comply with HIPAA, insurance regulations, and applicable organizational procedures. Maintain accurate records while protecting confidential patient and financial information. Maintain reliable attendance and consistent availability according to established schedules. Requirements 2+ years of experience in healthcare registration, financial clearance, patient financial services, or a comparable healthcare revenue-cycle environment. Strong knowledge of healthcare insurance coverage, eligibility verification, benefits, reimbursement rules, and payer processes. Strong mathematical, analytical, and problem-solving skills with exceptional attention to detail. Proficiency with Microsoft Office and the ability to quickly learn and navigate new software systems. Excellent written and verbal communication skills, with the ability to interact professionally with patients, providers, payers, and internal teams. Strong organizational and time-management skills, including the ability to prioritize multiple tasks and meet deadlines. Professionalism, tact, diplomacy, and strong interpersonal skills when handling sensitive financial and healthcare matters. Ability to work independently while contributing effectively within a collaborative team environment. Commitment to confidentiality, accuracy, compliance, and patient-centered service. An associate’s or bachelor’s degree is preferred. Experience with managed care coverage, reimbursement, medical terminology, medical coding, or medical office/hospital operations is a plus. Candidates must reside in an approved U.S. state for remote employment: Arkansas, Arizona, Colorado, Florida, Hawaii, Idaho, Illinois, Indiana, Kansas, Michigan, Missouri, Montana, Minnesota, North Carolina, Ohio, Oregon, Tennessee, Texas, Virginia, or Washington. Benefits Full-time, 100% remote position for eligible candidates residing in approved U.S. states. Day-shift schedule, 8 hours per day and 40 hours per week, with scheduling determined according to departmental and organizational needs. Supportive and collaborative team environment. Opportunities for professional development and continued skills growth. Opportunity to make a direct contribution to the patient experience by helping individuals navigate healthcare insurance and financial requirements. Pre-employment screening includes criminal background, reference, drug, health/immunization, and physical-demand screening, subject to applicable requirements.