Let’s get started
By clicking ‘Next’, I agree to the Terms of Service
and Privacy Policy
Jobs / Job page
Financial Clearance Specialist image - Rise Careers
Job details

Financial Clearance Specialist - job 1 of 2

Company Description

Experience the highest level of appreciation at UM Baltimore Washington Medical Center — named Top Workplace in the Baltimore area by The Baltimore Sun two years in a row (2019 & 2020); Top Workplace in the USA for 2021!  As part of the acclaimed University of Maryland Medical System, our facility is one of three ANCC Pathway to Excellence® designated hospitals in Maryland. UM BWMC features one of the state’s busiest emergency departments, as well as a team of experts who care for our community and one another.  The University of Maryland Baltimore Washington Medical Center (UMBWMC) provides the highest quality health care services to the communities we serve. Our medical center is home to leading-edge technology, nationally recognized quality, personalized service and outstanding people. We have 285 licensed beds and we’re home to 3,200 employees and over 800 physicians. Our expert physicians and experienced, compassionate staff are connected to medical practices in the local community as well as at University of Maryland Medical Center in downtown Baltimore. For patients, this means access to high-quality care and research discoveries aimed at improving Maryland’s health.  Our physicians and nursing staff specialize in emergency, acute, medical-surgical and critical care. In addition, our medical center is home to many Centers of Excellence, offering expert outpatient health care.

Job Description

General Summary:

Under general supervision, responsible for processing the patient, insurance and financial clearance aspects for both scheduled and non-scheduled appointments, including, validation of insurance and benefits, routine and complex pre-certification, prior authorizations, and scheduling/pre-registration.  Responsible for triaging routine financial clearance work.

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification.  These are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

  1. Processes administrative and financial components of financial clearance including, validation of insurance/benefits, medical necessity validation, routine and complex pre-certification, prior-authorization, scheduling/pre-registration, patient benefit and cost estimates, as well as pre-collection of out of pocket cost share and financial assistance referrals.
  2. Initiates and tracks referrals, insurance verification and authorizations for all encounters.
  3. Utilizes third party payer websites, real-time eligibility tools, and telephone to retrieve coverage eligibility, authorization requirements and benefit information, including copays and deductibles.
  4. Works directly with physician’s office staff to obtain clinical data needed to acquire authorization from carrier.
  5. Inputs information online or calls carrier to submit request for authorization; provides clinical back up for test and documents approval or pending status.
  6. Identifies issues and problems with referral/insurance verification processes; analyzes current processes and recommends solutions and improvements.
  7. Reviews and follows up on pending authorization requests.
  8. Coordinates and schedules services with providers and clinics.
  9. Researches delays in service and discrepancies of orders.
  10. Assists management with denial issues by providing supporting data.
  11. Pre-registers patients to obtain demographic and insurance information for registration, insurance verification, authorization, referrals and bill processing.
  12. Develops and maintains a working rapport with inter-departmental personnel including ancillary departments, physician offices, and financial services.
  13. Assists Medicare patients with the Lifetime Reserve process where applicable.
  14. Reviews previous day admissions to ensure payer notification upon observation or admission.
  15. Must be willing to travel between facilities as needed (applies to specific UMMS Facilities).
  16. Performs other duties as assigned.

Qualifications

Education and Experience

  1. High School Diploma or equivalent is required.
  2. Minimum 2 years of experience in healthcare revenue cycle, medical office, hospital, patient access or related experience.
  3. Experience in healthcare registration, scheduling, insurance referral and authorization processes preferred.

 

Knowledge, Skills and Abilities

  1. Knowledge of medical and insurance terminology.
  2. Knowledge of medical insurance plans, especially manage care plans.
  3. Ability to understand, interpret, evaluate, and resolve basic customer service issues.
  4. Excellent verbal communication, telephone etiquette, interviewing, and interpersonal skills to interact with peers, superiors, patients, and members of the healthcare team and external agencies.
  5. Intermediate analytical skills to resolve problems and provide patient and referring physicians with information and assistance with financial clearance issues.
  6. Basic working knowledge of UB04 and Explanation of Benefits (EOB).
  7. Some knowledge of medical terminology and CPT/ICD-10 coding.
  8. Demonstrate dependability, critical thinking, and creativity and problem-solving abilities.
  9. Knowledge of registration and admitting services, general hospital administrative practices, operational principles, The Joint Commission, federal, state, and legal statutes preferred.
  10. Knowledge of the Patient Access and hospital billing operations of Epic preferred.

Additional Information

All your information will be kept confidential according to EEO guidelines.

Compensation:

Pay Range: $18.17-$23.05

Other Compensation (if applicable): Shift Differentials

Review the 2024-2025 UMMS Benefits Guide

University of Maryland Medical System Glassdoor Company Review
3.5 Glassdoor star iconGlassdoor star iconGlassdoor star icon Glassdoor star icon Glassdoor star icon
University of Maryland Medical System DE&I Review
3.6 Glassdoor star iconGlassdoor star iconGlassdoor star icon Glassdoor star icon Glassdoor star icon
CEO of University of Maryland Medical System
University of Maryland Medical System CEO photo
Mohan Suntha, MD, MBA
Approve of CEO

Average salary estimate

$20610 / YEARLY (est.)
min
max
$18170K
$23050K

If an employer mentions a salary or salary range on their job, we display it as an "Employer Estimate". If a job has no salary data, Rise displays an estimate if available.

What You Should Know About Financial Clearance Specialist, University of Maryland Medical System

Are you ready to jump into an exciting role as a Financial Clearance Specialist at the University of Maryland Baltimore Washington Medical Center? At UM BWMC, we pride ourselves on providing top-notch healthcare and creating a supportive environment for all our team members. As a Financial Clearance Specialist, you'll play a vital role in our commitment to quality care by processing patient information, validating insurance, and ensuring everything runs smoothly for both scheduled and unscheduled appointments. You'll be responsible for a range of tasks including pre-certification and authorizations, scheduling, and handling financial clearances. Working alongside our expert medical team, you'll gather necessary data and communicate with various insurance providers, making sure that patients receive the timely care they need. You'll need a minimum of two years of healthcare experience along with a solid understanding of insurance terminology. We’re looking for someone who thrives in a fast-paced environment and possesses strong analytical skills to tackle challenges effectively. If you're passionate about making a difference in the healthcare landscape, we invite you to bring your skills to UM BWMC, where you’ll be part of a knowledgeable and compassionate team dedicated to improving community health. Here at UM BWMC, you'll not only enjoy a fulfilling career but also become part of a culture that values teamwork and excellence.

Frequently Asked Questions (FAQs) for Financial Clearance Specialist Role at University of Maryland Medical System
What are the primary responsibilities of a Financial Clearance Specialist at UM Baltimore Washington Medical Center?

As a Financial Clearance Specialist at UM Baltimore Washington Medical Center, your main responsibilities include processing insurance validations, pre-certifications, and prior authorizations for patient appointments. You'll be actively involved in verifying coverage eligibility and benefits, scheduling services, and ensuring all financial clearance aspects are handled efficiently. You'll also collaborate with healthcare providers to obtain the necessary clinical data needed for authorizations.

Join Rise to see the full answer
What qualifications are needed for the Financial Clearance Specialist position at UM Baltimore Washington Medical Center?

To qualify for the Financial Clearance Specialist role at UM Baltimore Washington Medical Center, you need at least a high school diploma and a minimum of two years of relevant experience in healthcare revenue cycles or patient access. Familiarity with medical terminology, understanding of insurance processes, and effective communication skills are essential for this position.

Join Rise to see the full answer
How does UM Baltimore Washington Medical Center support its Financial Clearance Specialists?

UM Baltimore Washington Medical Center offers a supportive environment that values teamwork and professional growth. As a Financial Clearance Specialist, you'll have access to continuous learning opportunities, a dedicated team, and a workplace culture recognized as a top workplace. You'll be equipped with the resources needed to excel in your role, including training on insurance processes and technological systems.

Join Rise to see the full answer
What skills are vital for success as a Financial Clearance Specialist at UM Baltimore Washington Medical Center?

Success as a Financial Clearance Specialist at UM Baltimore Washington Medical Center hinges on strong communication and interpersonal skills, analytical thinking, and proficiency in handling patient data and insurance details. A basic understanding of medical billing, knowledge of the Epic system, and the ability to resolve customer service issues effectively are key to performing well in this role.

Join Rise to see the full answer
What is the salary range for the Financial Clearance Specialist position at UM Baltimore Washington Medical Center?

The salary range for a Financial Clearance Specialist at UM Baltimore Washington Medical Center is between $18.17 and $23.05 per hour, based on experience and qualifications. Additionally, you can benefit from shift differentials and a comprehensive benefits package designed to enhance your overall work experience.

Join Rise to see the full answer
Common Interview Questions for Financial Clearance Specialist
How do you handle the verification of insurance coverage?

In my role as a Financial Clearance Specialist, I meticulously verify insurance coverage by using payer websites and real-time eligibility tools. I first confirm the patient's information, then check for copays, deductibles, and any prior authorization requirements, ensuring all details are accurate before proceeding with scheduling.

Join Rise to see the full answer
Explain a challenging situation you encountered with a prior authorization.

Once, I faced a situation where a prior authorization was initially denied due to missing clinical information. I effectively communicated with the physician's office to gather the necessary data, promptly re-submitted the updated authorization, and successfully secured approval for the patient.

Join Rise to see the full answer
What strategies do you use to manage multiple tasks effectively?

To manage multiple tasks effectively as a Financial Clearance Specialist, I prioritize based on urgency and deadlines. I use task management tools to organize my workload and periodically reassess my priorities throughout the day, collaborating with team members when needed.

Join Rise to see the full answer
How do you ensure that patient information is handled confidentially?

I understand the importance of patient confidentiality and adhere to HIPAA regulations strictly. I ensure that all patient information is stored securely and discussed only with authorized personnel, using encrypted communication methods when necessary.

Join Rise to see the full answer
What experience do you have with electronic health records (EHR) systems?

I have worked extensively with EHR systems, particularly in managing patient records and facilitating the insurance verification process. I am comfortable navigating these systems to retrieve information quickly and accurately to support financial clearance needs.

Join Rise to see the full answer
Describe how you handle discrepancies in insurance authorization.

When encountering discrepancies in insurance authorization, I take a systematic approach: I first gather all relevant details and documentation, then contact the insurance provider to resolve the issue. Maintaining clear communication with the patient and any involved medical offices is key to ensuring transparency during this process.

Join Rise to see the full answer
Why do you believe customer service is important in the role of a Financial Clearance Specialist?

Customer service in the Financial Clearance Specialist role is essential because positive interactions can significantly impact a patient's experience within the healthcare system. By effectively addressing concerns and providing accurate information, I help reduce patient anxiety and foster trust in our services.

Join Rise to see the full answer
What methods do you employ to stay up-to-date with changing insurance policies?

To stay updated with changes in insurance policies, I regularly attend workshops, subscribe to relevant industry newsletters, and participate in professional forums. Engaging with colleagues allows me to exchange insights and learn best practices for adapting to new regulations.

Join Rise to see the full answer
How would you deal with a patient who is frustrated with their billing situation?

In addressing a frustrated patient, I prioritize empathy and active listening. I assure the patient I am here to help and then clarify their concerns. After understanding their issue, I work with them transparently to identify solutions or escalate the matter if necessary.

Join Rise to see the full answer
What role does teamwork play in your work as a Financial Clearance Specialist?

Teamwork is integral to my role as a Financial Clearance Specialist. Collaborating with colleagues, such as physicians and ancillary staff, enhances our overall efficiency and ensures that patient needs are met promptly and accurately, fostering a sense of unity and shared purpose in our healthcare delivery.

Join Rise to see the full answer
Similar Jobs
Photo of the Rise User
Posted 8 days ago
Photo of the Rise User
Posted 4 days ago
Photo of the Rise User
Posted 11 days ago
Photo of the Rise User
iT1 Hybrid No location specified
Posted 9 days ago
Photo of the Rise User
Informa Group Plc. Hybrid 1468 W 9th St, Cleveland, OH 44113, USA
Posted 4 days ago
Photo of the Rise User
Posted 2 days ago

We dedicate every day to providing a better state of care in Maryland. We are committed to strengthening the social fabric of our communities with high quality care centered on patients and their families, and our size and geographical reach all...

1100 jobs
MATCH
Calculating your matching score...
DEPARTMENTS
SENIORITY LEVEL REQUIREMENT
TEAM SIZE
EMPLOYMENT TYPE
Full-time, on-site
DATE POSTED
March 14, 2025

Subscribe to Rise newsletter

Risa star 🔮 Hi, I'm Risa! Your AI
Career Copilot
Want to see a list of jobs tailored to
you, just ask me below!
LATEST ACTIVITY
A
Someone from OH, Lewis Center just viewed 34505367634 - Fraud Analyst at Activate Talent
Photo of the Rise User
Someone from OH, Dublin just viewed Senior Third-Party Risk Analyst at Fenergo
Photo of the Rise User
Someone from OH, Columbus just viewed US Product Designer at Praxent
Photo of the Rise User
Someone from OH, Cleveland just viewed Accounting Co-Op (Part-Time) at Avery Dennison
Photo of the Rise User
Someone from OH, North Ridgeville just viewed Product Manager at ShiftCare
Photo of the Rise User
Someone from OH, North Ridgeville just viewed Product Operations at Binance
Photo of the Rise User
Someone from OH, Mentor just viewed Sales & Service Lead - Pinecrest at Alo Yoga