You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a highly skilled Financial Clearance Specialist. The primary responsibility is to verify patient insurance coverage and eligibility, validate benefits, and maintain precise records. The specialist will also facilitate patient pre-registration, provide financial counseling, manage denial proactively, and ensure compliance with regulatory standards.

Key Responsibilities

• Insurance Verification: Confirm patient coverage and eligibility through various modalities, including payer portals and direct communication with insurance carriers.
• Benefit Validation: Determine patient financial liability by analyzing plan details, including deductibles and co-payments.
• Medical Documentation: Maintain precise records of insurance details and coverage limitations within the Electronic Health Record (EHR) system.
• Patient Pre-Registration: Gather and validate demographic data ensuring records are current and accurate.
• Financial Counseling & Communication: Explain benefit structures, provide cost estimates, and resolve financial concerns for patients.
• Proactive Denial Management: Mitigate claim denials by identifying coverage gaps and escalating complex cases as needed.
• Regulatory Compliance: Ensure duties align with HIPAA, state and federal regulations, and internal policies.
• Cross-Functional Collaboration: Work with scheduling, clinical staff, and prior authorization teams to streamline workflows.

Qualifications

• High school diploma or equivalent (GED).
• Proficient in payer types, interpreting CPT/ICD-10 coding, and medical terminology.
• Intermediate understanding of health insurance structures.
• Solid grasp of front-end revenue cycle functions, including prior authorization.

Experience

• 2+ years of experience in healthcare revenue cycle operations, with a focus on pre-access, patient registration, or financial clearance.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.