Financial Clearance Associate II

The Johns Hopkins Health System Corporation (JHHS) is a not-for-profit organization, academically based health system, dedicated to providing the highest quality patient health care in the treatment and prevention of human illness.

What awaits you:

• Room for growth
• Medical, Dental, and Vision Insurance.
• 403B Savings Plan w/employer contribution.
• Paid Time off & Paid holidays.
• Employee and Dependent Tuition assistance benefits.

This is a full time remote role. Applicants residing in MD, VA, DC, PA, DE and FL will be considered.

Must have prior authorization experience in a hospital setting- Cardiology/Radiology preferred.

Job Summary

Responsible for all administrative and financial components of financial clearance. Handles insurance verification and pre-authorization validation, submission, and obtaining a final determination from insurance plans. Implements process improvements. Resolves patient financial issues related to insurance prior authorizations. Communicates with insurance companies, physicians, administrators, department leaders, and other departmental staff to ensure services are financially cleared prior to service delivery to ensure an ideal patient experience.

Job Functions

• Obtains financial clearance for scheduled services and/or referrals prior to the date of service
• Secures required insurance authorizations, referrals, and notifications in accordance with payer requirements.
• Identifies health insurance benefit limitations, exclusions, and coverage issues per payer requirements.
• Ensures timely and accurate documentation of all financial clearance activities in Epic/EMR system.
• Obtain elective, urgent and emergent admissions notifications if not completed prior to or at time of service

Qualifications

• High School Diploma/GED or equivalent (Required)
• 2+ years of experience in financial operations or healthcare finance (Required)
• Strong attention to detail and self-directed to consistently ensure data integrity and accuracy.
• Proficient knowledge; performs standardized, assigned duties and tasks in Pre-Service Revenue Cycle Management.
• Intermediate proficiency and experience using Microsoft Office Package (Excel, PowerPoint, Word, Outlook).