Financial Clearance Coordinator

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Colorado Retina Associates is looking for a Financial Clearance Coordinator at our Lafayette Location!

Colorado Retina Associates is the premier retina practice of the Rocky Mountain region.  Come join a team that strives to provide advanced care and cutting-edge therapies for our patients.  Just as we aim to have top notch patient care we aim to take great care of our team members by providing competitive salary & benefits, continuing education and advancement programs, opportunity to work with the top-ranked retina specialists in the US and state-of-the-art equipment and retina treatment methods.

Colorado Retina Associates is complying with the Covid-19 Vaccine Mandate. Colorado Retina requires employees to be vaccinated as a condition of employment, subject to accommodation. All candidates, upon hire, will be required to provide proof of vaccination or have a valid accommodation.

Pay Range: $19.77 - $31.62

Job Type: Full Time, Onsite at our Lafayette Location

Position Summary:

The Financial Clearance Coordinator performs all necessary activities to ensure care can proceed as scheduled including verifying insurance coverage, confirming referral requirements, requesting referrals when needed, verifying payer coverage of proposed treatment plans, requesting and tracking prior authorizations, and appealing denied authorization requests.  This role reviews patient accounts for accuracy and corrects as necessary, prepares Good Faith Estimates (GFEs), collects payment in advance or provides direction to office staff to do so.

This position works directly with clinic  personnel, insurance companies, funding organizations, and patients.

Job Duties:

• Reviews patient appointment schedules in advance and confirms that appointments are scheduled correctly, that insurance coverage is active and accurate and is attached to the appointment.
• Utilizes eligibility systems, payer web portals, or phone calls to confirm active insurance coverage as needed.
• Confirms prior authorizations and referrals are in-place; confirms diagnosis submitted supports medical necessity; requests referrals and authorizations as needed and documents in NextGen; appeals denied prior authorization requests
• Adds alerts and authorizations into NextGen and Nextech
• Submits benefits investigation (BI) requests to drug funding organizations to confirm benefits coverage status
• Follows up on paperwork process through to final decisions for co-pay assistance programs
• Reviews patient account balances for accuracy; corrects as necessary; explains balances to office staff and patients as needed
• Provides cost and out-of-pocket expense estimates to patients as needed
• Assists patients with payment arrangements and with financial applications
• Maintains patient confidentiality at all times
• Shows dependability and reliability in achieving goals

Job Requirements:

• High School Diploma or GED
• Associate or bachelor’s degree preferred or a combination of years and relative
• Two or more years' experience in a billing setting
• Strong customer service experience

Preferred Skills/Experience:

• Broad knowledge and experience in Insurance authorizations and funding programs
• Above average skills in Insurance navigation and eligibility
• Excellent communication skills and a positive attitude.
• Ability to make independent decisions and exercise discretion when working with patients and insurance
• Excellent analytical and problem-solving
• Strong verbal and written communication
• Familiarity with medical terminology and abbreviations.

Our benefits include:

• Competitive salary
• Safe harbor/profit sharing plan
• Full medical, dental, and vision insurance
• Pet insurance
• Legal, life, accident, disability, and hospitalization insurance