Financial Clearance Specialist
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Key details
- Location
- United States
- Work style
- Remote
- Level
- Mid level
- Job type
- Full-time
- Experience
- 2–5 yrs
- Function
- Finance & Accounting
- Focus area
- other
- Posted
- 7h ago
Skills
About the role
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Financial Clearance Specialist based in the United States.
In this role, you will play an important part in ensuring accurate and timely financial clearance for patient accounts within a growing precision medicine and healthcare diagnostics environment. You will oversee insurance eligibility verification, investigate billing discrepancies, and help ensure that claims are complete and submitted correctly to insurance providers. Working closely with healthcare providers, patients, insurance companies, and internal teams, you will help resolve coverage issues and maintain efficient revenue cycle operations. Your attention to detail and understanding of medical billing procedures will directly support a smooth financial experience for patients. This is a full-time opportunity for a detail-oriented professional who enjoys problem-solving and working in a fast-paced, collaborative healthcare environment.
Accountabilities
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Verify insurance eligibility: Review patient insurance policies and benefit coverage to confirm eligibility for laboratory services and identify potential coverage limitations.
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Coordinate with stakeholders: Communicate with internal teams, healthcare clinics, patients, and insurance providers to obtain coverage information, clarify discrepancies, and resolve eligibility issues.
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Maintain accurate documentation: Record insurance verification results, patient account information, and relevant updates accurately in revenue cycle management systems.
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Resolve claim errors: Investigate and correct claim errors identified by billing systems, including missing information, coding issues, billing discrepancies, and insurance rejections.
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Address medical necessity discrepancies: Review and resolve issues related to medical necessity requirements to support accurate and compliant claim submissions.
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Ensure clean claim submissions: Help prepare and process complete, accurate claims within established timelines to minimize delays and improve reimbursement efficiency.
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Maintain regulatory compliance: Handle sensitive patient information responsibly and follow applicable HIPAA requirements, internal policies, and billing procedures.
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Collaborate on operational improvements: Work with colleagues to resolve outstanding account issues, improve workflows, and support additional financial clearance activities as needed.
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High school diploma or equivalent qualification.
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At least 2 years of professional experience in medical billing, insurance eligibility verification, financial clearance, or a related healthcare revenue cycle position.
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Understanding of medical insurance policies, patient benefits, billing procedures, and healthcare claim terminology.
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Knowledge of HIPAA regulations and appropriate handling of Protected Health Information (PHI).
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Experience reviewing insurance coverage and identifying potential issues affecting patient account clearance.
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Ability to investigate and resolve claim errors, including missing documentation, coding discrepancies, and billing issues.
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Strong analytical, organizational, and problem-solving skills, with excellent attention to detail and accuracy.
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Excellent written and verbal communication skills, with the ability to interact professionally with patients, healthcare providers, insurance companies, and internal stakeholders.
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Strong interpersonal skills and the ability to work collaboratively in a fast-paced environment.
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Ability to manage multiple priorities, meet deadlines, and maintain accuracy when handling sensitive financial and patient information.
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Familiarity with laboratory billing and revenue cycle management platforms is highly desirable, particularly