Reporting to the Financial Verification Manager, the Financial Verification Specialist is responsible for fielding and resolving patient financial clearance inquiries via phone and other potential contact methods, obtaining benefits information, verifying that required authorizations are in place, and for meeting timeline standards established by the Clinical Health Network for Transformation (CHN). Expectations of this role include providing exceptional customer service, striving to anticipate and meet the needs of CHN consumers, treating all consumers and colleagues with dignity and respect, and working collaboratively with colleagues to achieve quality and performance standards.
Essential Functions
Maintain competence and use critical thinking skills to promptly resolve consumer inquiries; some interactions may include:- Determining eligibility for services, Providing price estimates for scheduled services, Creating and maintaining payment plans, Fielding inquiries about statements and Explanations of Benefits (EOB), Providing financial assistance, Addressing patient complaints and resolving issues effectively Contact insurance companies by phone, fax, or online portal to obtain insurance benefits, eligibility, and authorization information and update CHN systems with accurate information obtainedCommunicate to CHN affiliate and/or call center partners of situations where rescheduling is necessary due to lack of authorization or limited benefits and has been approved by clinical personnelMeet or exceed audit accuracy and productivity standard goals determined by CHN leadership, ensuring that obtained benefits, authorizations, and/or pre-certifications are accurate according to the actual test, procedure, or visit type being performed.Ensure integrity of patient accounts by working error reports as requested by management and entering appropriate and accurate dataUse utmost caution that obtained benefits, authorizations, and pre-certifications are accurate according to the actual test, procedure, or visit type being performedEnsure all benefits, authorizations, pre-certifications, and financial obligations of patients, are documented on account memos accurately, and in a detailed manner to ensure patients can use their insurance to get the care they needAssist team with reports and projects to maintain team and individual productivity standards and goals, as directedWork patient accounts for benefits, monitors accounts for change in insurance status prior to registration, and sends updates to appropriate areas for follow upContact patient to notify when visits are canceled or rescheduledMaintain a current and thorough knowledge of utilizing online and system tools availableAdhere to CHN, departmental, and member affiliate policies and procedures, including HIPAA regulationsEnsure compliance with all CHN compliance standards and to all rules and regulations of all applicable local, state, and federal agencies and accrediting bodiesWork and build trust across cultural differencesCreates and promotes a culture of continuous improvementDemonstrates a commitment to CHN and Planned Parenthood’s mission related to health equity, especially centering racial equity, and deep sense of accountability to communityDemonstrates a commitment to learning about and enhancing practices related to racial equity and the impact of structural racism on healthcare systemsProvides positive and development feedback and accountability related to practices including, but not limited to, equity
The above duties and responsibilities are not an exhaustive list of required responsibilities, duties, and skills. Other duties may be added, and this job description can be amended at any time.
Qualifications and Experience (Required)
High school diploma or equivalent and at least two years of experience in customer service- Ability to work a flexible work schedule including evenings and weekends Demonstrated dedication to Planned Parenthood’s mission, vision, and valuesStrong analytical and problem-solving abilitiesProficiency with Microsoft software (Excel, etc.)Demonstrated ability to maintain a customer-centric service approachExcellent written and verbal communication skills and ability to collaborate and interact with all levels within and outside of CHN, if necessaryStrong interpersonal skills and the ability to build relationshipsExcellent time management and problem-solving skill
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- Ability to manage multiple tasks simultaneously with minimal supervisionAbility to work independentlyStrong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiencesEnglish language proficiency
Qualifications and Experience (Preferred)
Associate degree in a related field or equivalent experience- y
- One year experience with patient financial services, patient access, customer service, or related area (i.e., registration, finance, collections, customer services, medical office, or contract management)Secondary language proficienc
Key Requirements
Commitment to advancing race(+) equity in one’s work: interested in expanding knowledge about the role that racial inequity plays in our society- s
- Awareness of multiple group identities and their dynamics, bringing a high level of self-awareness about personal identity, empathy, and humility to interpersonal interactionsDemonstrated ability to communicate clearly and directly as well as hear and act on feedback related to identity and equity with the aim to learnStrong sense of accountability to equitable practicesUnderstanding of the impact of identity dynamics on organizational cultureCommitment to CHN and Planned Parenthood’s In This Together service ethos, workplace values, and service standard
Above Position Compensation Range: $18.00/hour (Minimum); goes up based on relevant experience- Geographic Differentials available for residences of NYC
- Health Care Coverage (Medical, Dental, & Vision); eligibility for full-time, regular employees on date of hire
- Flexible Spending Accounts and Health Savings Account
- Short-Term Disability and Basic Life & AD&D Insurance provided by CHN
- Voluntary elections for Long Term Disability and Additional Life & AD&D Insurance available at cost
- Employee Assistance Program
- Retirement Plan, 3% employer match after one year of service
- Paid Time Off Program includes accrual-based PTO and nine (9) paid Holidays
Clinical Health Network for Transformation (CHN) is an equal employment opportunity employer. We comply with all applicable laws prohibiting discrimination based on race, color, religion, gender and gender expression/identity, age, ethnicity, national origin, ancestry, physical or mental disability, uniformed service member/veteran status, marital status, medical condition, pregnancy, sexual orientation, citizenship status, genetic information, as well as any other category protected by federal, state, or local. We are committed to building an inclusive workplace that values racial & social justice. We strongly encourage all persons to apply, including people of color and members of the LGBTQ community.