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Financial Clearance Representative Part Time Highland Hills Job in Cleveland, Ohio US

Job Summary

University Hospitals Health System
Cleveland, OH
Government and Military
Job Type
Part Time
Years of Experience
2+ to 5 Years
Job Reference Code

Financial Clearance Representative Part Time Highland Hills

About the Job


Job Summary:

As an essential member of the UH Patient Access Services team, Financial Clearance Representatives ensure optimal reimbursement for UH ambulatory and inpatient services from third party payers. Financial Clearance Representatives are experts in patient/physician relations, registration, scheduling, and precertification. Duties include but are not limited to the following:

Obtains prior authorization for inpatient and outpatient services from government, commercial, and state agencies. Submits timely electronic and verbal notifications and clinical documentation in accordance with contractual requirements. Communicates potential issues and initiates resolution steps.
Performs financial review of patient encounters and prepares patient liability estimates.
Makes patients fully aware of financial obligations and eligibility for programs that may provide financial aid; explains and collects co-pays, deductibles and other patient balances; provides patient education regarding third party coverage and liabilities.
Verifies, obtains any missing information and documents patient insurance information at time of service.  This includes verifying health insurance coverage, eligibility dates, obtaining in and out of network benefit amounts, out of pocket limit, deductible information, life time maximum, co-payment amount, and the like.
Performs a financial review of patient information in order to identify self-pay and uninsured cases.
Refers patients to appropriate Financial Counselor.
Ensures urgent/emergent cases are worked within 1 business day of admission and all elective cases are worked prior to date of service.
Refers Worker's Compensation and uninsured accounts to appropriate agency within 48 hours of admit.

Recruits and trains patients to access Personal Health Record (PHR).

Ensures achievement of department productivity and quality standards.
Maintains up-to-date knowledge of internal (UH) and external (third party payer) computer applications/systems, insurance/government regulatory requirements and UH/PAS policies/procedures used within the department.
Executes appropriate activities to ensure compliance.
Develops trusting and supportive working relationships with physicians, insurance/third party reps.
Actively participates in UH emergency preparedness.
Maintains a clean and organized work area.
Will be cross-trained to perform other duties as assigned.
May be scheduled to work at off-sites.


(This role encounters Protected Health Information (PHI) as part of regular responsibilities.  UH employees must abide by all requirements to safely and securely maintain PHI for our patients.  Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.)



Minimum 3 years' experience in hospital billing/finance/Patient Access/healthcare, working with insurance companies/third-party payers or related experience, required
Knowledge of managed care insurance requirements is essential


High School diploma or GED required. Degree or progress towards degree preferred
A bachelor's degree will be accepted in lieu of 1 year of work experience.
Medical Terminology preferred
Up-to-date CHAA - (CHAA is a National Association of Healthcare Access certification for Healthcare Access Associates) or related medical certification preferred

Demonstrated ability to use PCs (and toggle between multiple applications), Microsoft Office suite, and general office equipment (i.e. printers, scanners, electronic signature pads, copy machine, multi-line phone, FAX machine, etc.) required
Must be detail-oriented and organized, with good analytical and problem solving ability
Notable client service, communication and relationship building skills required
Ability to function independently and as a team player in a fast-paced environment required
Must have strong written and verbal communication skills
Professional demeanor required

Equal Opportunity Employer – minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity

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