Logo for UMass Memorial Medical Center

Financial Clearance Specialist - Remote

Role overview

Qualifications

  • Minimum High School Diploma or G.E.D., business concentration preferred
  • Four plus years of experience within a business office setting, hospital revenue cycle preferred, Physician office or collection agency
  • Prior experience in a healthcare environment required
  • Associate degree or higher preferred

Responsibilities

  • Assessing and verifying patient information for medical services
  • Collects co-pays, deductibles, coinsurances, and down payments
  • Receives and processes patient financial liability payments
  • Initiates contact with insurance companies to obtain eligibility and gather patient billing information

Key facts

Other skills

  • Computer Literacy
  • Customer Service
  • Communication
  • Teamwork
  • Problem Solving

About the company

UMass Memorial Medical Center logo

UMass Memorial Medical Center

Hospitals & Health Care

The flagship member of the UMass Memorial Health system, UMass Memorial Medical Center is the trusted academic medical center of central Massachusetts and the clinical partner of the UMass Chen Medical School. With over 800 beds (including bassinets) and 7,000 caregivers, UMass Memorial Medical Center is dedicated to ensuring the health and wellbeing of our communities across Central Massachusetts. From delivering around the clock lifesaving care to persevering through a pandemic, our commitment to our communities never wanes. We use knowledge and innovation to deliver breakthrough medicine. To make life better for those we serve. We stand for quality, compassion, dignity, opportunity, and fairness. And we are relentless in our pursuit of healing. UMass Memorial Medical Center includes three campuses located in Worcester, MA: • Hahnemann Campus • Memorial Campus • University Campus With the latest medical technology and support services, we are the tertiary care referral center for central and western Massachusetts. In addition to being the premier source of academic and clinical excellence in primary care, our care teams feature highly trained specialists who are nationally acclaimed for their expertise and leadership in areas such as: • Cardiovascular care • Neurosciences, including the region’s only Joint Commission accredited comprehensive stroke center • Orthopedics • Hematology/oncology • Liver and kidney transplantation • Children’s services, as part of the region’s only Children’s Medical Center • Women’s services • Pediatric newborn medicine and the region’s only level III Neonatal Intensive Care Unit • Trauma/emergency medicine and the region’s only designated level I trauma center • Life Flight, New England’s first hospital-based air ambulance Comprehensive, Award Winning Care in Central Massachusetts

Company details

Company typeXLarge
IndustryHospitals & Health Care
Company size10001

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Job description

Are you a current UMass Memorial Health caregiver? Apply now through Workday.

Exemption Status:

Non-Exempt

Hiring Range:

$20.94 - $29.27

Please note that the final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations.

Schedule Details:

Monday through Friday

Scheduled Hours:

8:00am - 4:30pm

Shift:

1 - Day Shift, 8 Hours (United States of America)

Hours:

40

Cost Center:

99940 - 5478 Financial Clearance

Union:

SHARE (State Healthcare and Research Employees)

This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.

Everyone Is a Caregiver

At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.

Responsible for assessing and verifying patient information for scheduled for medical services. This requires verification of patient’s demographic, financial and insurance information. Collects co-pays, deductibles, coinsurances, and down payments. Provides estimates for services when appropriate. Receives and processes patient financial liability payments for current and past balances. The focus is to collect patient liabilities prior to service and to resolve any insurance and financial issues prior to services being rendered. Reschedules appointments when appropriate under the guidance of department leader. This position is the front line for customer service, pre-registration and access to care for scheduled services.

I. Major Responsibilities:
1. Initiates contact with insurance companies to obtain eligibility, gather accurate patient billing information, and performs collections with outstanding accounts receivable.
2. Accurately estimates the patient financial liability (copayments, deductibles, coinsurances, deposits, etc. via obtaining accurate demographic and financial information). Answers patient inquiries regarding their liability and able to explain the variables involved.
3. Receives and processes patient payments.
4. Ensures pre-certification authorization and or referral is in placement prior to service being rendered.
5. Appropriately referring patients to Financial Counselors or Business Office dependent on need of patient.
6. Reschedules appointments when requested by patient or, under advisement of department leader, when due to financial circumstances appointment requires postponement.
7. Enters clear, concise notes concerning financial clearance status in system based on communications.
8. Demonstrate knowledge and understanding of all job-related policies and procedures and adheres to and consistently applies the Financial Clearance Policy in all patient cases.
9. Assesses gaps in patient coverage to determine patient financial exposure prior to rendering service.
10. Consistently demonstrates ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary.
11. Performs other duties as assigned, or directed, to ensure smooth operation of the department/unit.

II. Position Qualifications:

License/Certification/Education:
Required:
1. Minimum High School Diploma, or G.E.D., business concentration preferred.
Preferred:

1. Associate degree, or higher, preferred.

Experience/Skills:
Required:
1. Four plus (4+) years of experience within a business office setting, hospital revenue cycle preferred, Physician office or collection agency.
2. Prior experience in a healthcare environment required.  
 
Preferred:
1. Working knowledge of personal computers and business office applications preferred.
2. Familiarity with hospital computer systems is a plus.
3. Knowledge of third party collections and reimbursement preferred.

Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements.

Department-specific competencies and their measurements will be developed and maintained in the individual departments.  The competencies will be maintained and attached to the departmental job description.  Responsible managers will review competencies with position incumbents.

III. Physical Demands and Environmental Conditions:

On-the-job time is spent in the following physical activities:
1. Stand - 1/3
2. Walk - 1/3
3. Sit - 2/3
4. Talk or hear - 2/3
5. Uses hands to finger, handle or feel - 2/3

This job requires that weight be lifted, or force be exerted:
1. Up to 10 pounds - 1/3

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We’re striving to make respect a part of everything we do at UMass Memorial Health – for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.

As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.

If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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