Financial Clearance Specialist, PRN

Job Requirements At UMMS, we are committed to working together to build and sustain a culture of excellence by delivering compassionate, high-quality care and exceptional service to our patients, families, and communities.

The Financial Clearance Specialist is responsible for ensuring patients are financially cleared for scheduled and non-scheduled healthcare services by completing insurance verification, authorization, pre-certification, registration, and financial counseling activities. Under general supervision, this role supports the revenue cycle by validating insurance benefits, obtaining required authorizations, estimating patient financial responsibility, collecting applicable payments, and facilitating financial assistance referrals.

The Financial Clearance Specialist serves as a liaison between patients, providers, payers, and internal departments to ensure timely access to care while minimizing authorization-related delays and denials. Key Responsibilities Perform insurance eligibility and benefits verification for scheduled and unscheduled services. Obtain and document routine and complex pre-certifications, prior authorizations, and referrals required by insurance carriers.

Review medical necessity requirements and ensure compliance with payer guidelines. Monitor and follow up on pending authorization requests to ensure timely approval. Coordinate with physician offices and clinical staff to gather documentation necessary for authorization requests.

Research and resolve authorization, referral, and insurance-related issues that may delay patient services. Work Experience Education & Experience High School Diploma or GED required. Minimum of two (2) years of experience in healthcare revenue cycle, patient access, registration, scheduling, medical office, hospital operations, or a related healthcare environment required.

Experience in healthcare registration, scheduling, insurance referral and authorization processes preferred Knowledge, Skills, and Abilities Knowledge of medical terminology, insurance terminology, and healthcare reimbursement practices. Understanding of commercial, government, and managed care insurance plans. Knowledge of authorization, referral, and eligibility verification processes.

Ability to prioritize multiple tasks and work in a fast-paced environment. Basic knowledge of UB-04 billing forms, Explanation of Benefits (EOBs), CPT, ICD-10 coding, and healthcare billing practices.

days shift