Financial Clearance Spec III

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What Awaits You?

• Career growth and development
• Diverse and collaborative working environment
• Paid Time Off
• Affordable and comprehensive benefits package

Johns Hopkins All Children's Hospital is the number one children's hospital in Florida according to the 2024-2025 U.S News & World Report and Survey.

POSITION SUMMARY:

Fin Clearance Spec III is responsible for all administrative and financial components of financial clearance. Financial Clearance components include but are not limited to eligibility validation, benefits verification, authorization, calculating patient responsibility, explaining financial responsibility to the patient's family. Responsible for documenting pertinent information into appropriate systems. Requires integral communication with patients, insurance companies, department administrators, physicians, and other departmental staff to ensure the ideal patient experience. Level III typically is assigned to the Specialized Service Unit (CDH & Transplant) or Rehab Services.

Hours: 40 Hours Per Week, Day Shift,

7:30am-4pm, Hybrid- in office 2 days per week.

Location: All Children's Hospital St. Petersburg, FL

KEY ACCOUNTABILITIES:

1. Ensures all scheduled patients are financially cleared with health plans prior to the date of service to protect the financial well-bring of the organization.

1. Validates and documents patient eligibility and ensures that scheduled services are a Covered Benefit to ensure patients are eligible for insurance coverage.
2. Ensures all scheduled services are authorized and appropriate notification and/or referral is obtained prior to the date of service to ensure payment for services.
3. Accurately calculates patient responsibility or patient estimate using appropriate tools; communicates financial responsibility to patient/guarantor prior to the date of service; attempts to collect any patient responsibility which may include prior balances; provides payment options and/or financial assistance screening (if necessary); and works with families to determine which payment arrangement works best for their particular situation in order to provide care to our families.
4. Provides an excellent patient-centered experience to physicians, coworkers, patients and families and all other internal and external customers to provide a positive experience with JHACH.

QUALIFICATIONS:

• A minimum of a High School diploma, GED, Certificate of Completion or equivalent achievement.
• 3 years healthcare experience in scheduling, registration, authorizations, business office, health plan, physician practice, surgery center or hospital in a business capacity.
• 3 years of experience working with health plan and payer authorization requirements and clinical policies.

• Comprehensive knowledge of third-party payer requirements, computer literacy and customer service skills.
• Working knowledge of CMS and other governmental programs.