Patient Financial Clearance Representative I (Remote)

This is a Fully Remote Job About Our Client: The organization operates within the healthcare sector, addressing challenges related to patient financial clearance and insurance verification. It manages complex payer systems including Medicare, Medi-Cal, Workers Compensation, and various Managed Care plans, working to secure accurate authorizations and insurance verifications for patients according to established regulations and policies. About the Opportunity: The PATIENT FINANCIAL CLEARANCE REPRESENTATIVE I role is responsible for verifying insurance coverage and securing necessary authorizations to minimize financial risk for the organization. This position ensures timely and accurate processing of patient insurance information, contributing to the organization's financial operations and compliance with healthcare payer requirements. Responsibilities: Complete insurance verification and benefit determination using electronic systems and payer resources Document co-pays, deductibles, and coverage details accurately Contact patients to update insurance information as needed Process Medicare Secondary Questionnaires when applicable Apply authorization rules across multiple payors within assigned queues Develop knowledge of procedures and diagnoses relevant to assigned service lines Communicate with clinics and providers to obtain information for authorizations Follow up on pending authorizations and referrals to ensure timely completion Assist in escalation for peer-to-peer appeal reviews with payors Prioritize work to optimize authorization completion and minimize financial risk Identify and escalate coverage or financial clearance risks Refer cases to financial counseling when authorization is delayed Report issues or errors to department management Maintain clear documentation and communication Manage inbound and outbound calls, respond promptly to inquiries Assist with special projects and serve as a resource for other teams Perform additional duties as assigned Requirements: High school diploma or GED equivalent Minimum one year of experience in patient registration, insurance verification, and authorization in a medical setting Preferred experience with Epic software No licenses or certifications required Pay Range and Compensation Package: Base pay generally starts at $34.40 to $38.72 per hour Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note: TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.