Responsibilities
- Review and confirm administrative and financial details for financial clearance, including insurance benefit verification, medical necessity assessments, and pre-authorization for standard and complex procedures.
- Secure necessary pre-certifications, approvals, and physician referrals for scheduled patient visits.
- Advise on adjustments to patient schedules and care plans to meet authorization requirements and payer regulations.
- Serve as a point of contact among patients, insurance carriers, and healthcare providers to secure prior approvals for planned services.
- Resolve financial clearance issues and provide timely guidance and support to patients and medical teams.
- Prioritize and process urgent clearance requests efficiently.
- Confirm the accuracy of patient demographic data during intake and processing.
- Update patient registration records to reflect current payer policies and changes.
- Review, modify, or delete user-entered referral tracking data and finalize referral statuses.
- Adjust appointment dates within referral systems, manage referral queues, suppress expiration alerts, and use templates for consistency.
- Use analytical thinking to detect and resolve potential clearance obstacles before they arise.
Other
- Equal Opportunity Employer: 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
