Insurance Clearance Specialist

Job Summary

To support the coordination of care processes, the full-time Insurance Clearance Specialist will manage insurance authorizations for inpatient and outpatient services, ensuring compliance with payor guidelines while working remotely Monday through Friday.

Key responsibilities

• Acquires and maintains knowledge of payor requirements and performs insurance authorization by analyzing clinical data
• Consults with patients regarding uninsured status and communicates potential financial responsibilities when authorization is not obtained
• Manages pre-registration and registration processes, ensuring accurate entry of patient demographic and insurance information

Required qualifications

• High School Graduate
• Typically requires 1 year of experience in healthcare, insurance, call center, or customer service settings
• Understanding of basic human anatomy and medical terminology
• Ability to prioritize and organize workload effectively
• General computer knowledge and proficiency with stand-alone software for eligibility verification