Financial Clearance Specialist

Job Description Summary:

At Logan Health, we're more than just a healthcare provider—we're a community. Nestled in the heart of Montana, we are committed to delivering exceptional care to our patients while fostering a supportive and collaborative work environment for our team. As a member of Logan Health, you'll be part of a dynamic team that values compassion, innovation, and excellence. We offer opportunities for growth, comprehensive benefits, and a chance to make a meaningful impact in the lives of those we serve. Come join us and experience the Logan Health difference, where your passion meets purpose in a place, you’ll be proud to call home.

Are you passionate about ensuring patients have a seamless financial experience in healthcare? At Logan Health, we are seeking a detail-oriented and proactive Financial Clearance Specialist to join our team. In this vital role, you will be responsible for verifying insurance eligibility, securing benefits, and estimating patient liabilities to prevent denials and optimize reimbursements. Your expertise in managing insurance verification and maintaining accurate payment details will help us minimize financial risk and deliver exceptional service to our patients, all while supporting our mission to provide high-quality healthcare.

Key Responsibilities:

• Initiate insurance verification processes using reports outside of Meditech Worklists.

• Confirm eligibility and secure full benefits coverage from insurance companies and employers, ensuring accurate demographic information and benefit coordination (COBs).

• Verify Medicare accounts, cross-check other providers, determine prior Medicare days, and notify the physician's office if changes to admit status are needed.

• Verify insurance coverage for both inpatient and outpatient accounts according to department protocols.

• Determine pre-certification and referral requirements as necessary.

• Address out-of-network barriers with providers and document accordingly.

• Estimate and collect patient liabilities before services, following cash management policies.

• Maximize collections by securing co-payments and personal balances as per department protocols.

• Handle accounts efficiently, providing necessary documentation to stakeholders for approval.

• Review and resolve claim edits to ensure timely billing submission.

• Collaborate with the Authorization team to secure required authorizations and referrals.

• Maintain compliance with HIPAA regulations throughout the insurance verification process.

• Stay up-to-date with insurance rules, regulations, and industry changes to ensure accurate plan identification and contract compliance.

• Continuously develop skills and knowledge to remain current with industry trends and best practices.

• Maintain regular and consistent attendance as scheduled by department leadership.

• Perform additional duties as required.

Basic Qualifications:

• 2+ years of experience in registration, financial clearance, or patient financial services.

• Strong understanding of insurance coverage rules and reimbursement guidelines.

• Proficient in math and analytical skills.

• Experience with Microsoft Office Suite.

Preferred Qualifications:

• Associate or Bachelor’s degree.

• Knowledge of managed care coverage and reimbursement rules.

• Familiarity with medical terminology and coding.

• Understanding of HIPAA and confidentiality regulations.

• Strong organizational skills, attention to detail, and ability to prioritize tasks.

• Ability to work independently and as part of a team.

• Excellent verbal and written communication skills for engaging with diverse audiences.

• Strong interpersonal skills to manage sensitive and confidential situations with professionalism.

This position offers full-time remote work.

To be eligible, you must reside in one of the following states:  

• Arkansas

• Arizona

• Colorado

• Florida

• Hawaii

• Idaho

• Illinois

• Indiana

• Kansas

• Michigan

• Missouri

• Montana

• Minnesota

• New Mexico

• North Carolina

• Ohio

• Oregon

• South Dakota

• Tennessee

• Texas

• Virginia

• Washington

• Wyoming

Shift:

Day Shift - 8 Hours (United States of America)

Schedule Details:

Please know schedules and shifts are subject to change based on patient care and department/organizational needs.

We are committed to creating a supportive, team-driven environment where your skills can flourish. Our organization operates 24/7, offering flexibility in your schedule while empowering you to be a part of something bigger—improving healthcare outcomes for all.

Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.

Notice of Pre-Employment Screening Requirements

If you receive a job offer, please note all offers are contingent upon passing a pre-employment screening, which includes:

• Criminal background check

• Reference checks

• Drug Screening

• Health and Immunizations Screening

• Physical Demand Review/Screening

Equal Opportunity Employer

Logan Health is an Equal Opportunity Employer (EOE/AA/M-F/Vet/Disability). We encourage all qualified individuals to apply for employment. We do not discriminate against any applicant or employee based on protected veteran status, race, color, gender, sexual orientation, religion, national origin, age, disability or any other basis protected by applicable law. If you require accommodation to complete the application, testing or interview process, please notify Human Resources.