Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).
Job Summary
The Financial Clearance Specialist role ensures seamless and accurate processing of financial clearance procedures. Responsibilities include contacting insurance companies, physicians, and patients to ensure patient demographic and insurance information is collected, and that a financial clearance determination can be made. It will also inform patients of their rights, financial policies, and collect patient liabilities.
Duties & Responsibilities
Process and verify administrative and financial components of financial clearance including validation of insurance benefits, medical necessity, routine and complex pre-certification, prior-authorization, scheduling and pre-registration, patient benefit and cost estimates, and pre-collection of out-of-pocket cost share.
Obtain pre-certifications, authorizations, and referrals for upcoming appointments.
Communicate recommended changes to schedules and care planning to ensure alignment with authorization requests and payor compliance
Liaison between patient, insurance payors and providers to obtain prior authorization for prescheduled services
Effectively address issues and offer information and support to both patients and physicians concerning financial clearance matters
Process stat request prioritization
Verify demographic information
Apply payor changes to registration
Verify, edit and/or remove user defined referral counts editing final status of referrals
Edit the scheduled date within the referral, pend referrals to any pools, suppressing expiring referrals messages, accessing assigned referral work queues, defer/activate referral work queue items, use referral templates
Apply critical thinking skills to identify and resolve problems proactively
Qualifications & Competencies
High School Diploma or equivalent
3+ years’ experience with patient registration in a hospital or physician office, directly with obtaining patient demographic and financial information, handling insurance verification and obtaining authorizations
Proficient with commercial and government insurance plans, payer networks, government resources
Proficient with medical and insurance terminology
Strong customer service skills, including ability to understand, interpret, evaluate, and resolve basic to complex service issues.
Strong attention to detail and accuracy
Excellent verbal and written communication, telephone etiquette, interviewing, and interpersonal skills to interact with peers, management, patients, client, and external agencies
Ability to work with a variety of stakeholders
Proficient in utilizing a variety of computer applications and software, including but not limited to Microsoft Office Suite, Internet Explorer, and other relevant programs
Proven track record in roles that involve managing multiple critical priorities, with a focus on delivering high-quality results and meeting performance metrics
Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $20.00 to $23.00 per hour. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills.
SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.
California Job Candidate Notice
Savista is a healthcare consulting and revenue cycle management services company that partners with healthcare organizations to address critical challenges in clinical quality, patient experience, and financial performance. The company specializes in revenue cycle improvement services, including medical coding, clinical documentation review, and billing optimization. Savista works with hospitals, physician practices, and healthcare systems to ensure accurate coding, compliance with regulatory requirements, and proper reimbursement. The company operates under core values of Commitment, Authenticity, Respect, and Excellence (CARE) while supporting clients' financial success and community health outcomes.
