Financial Clearance Coordinator

				Overview:

The Financial Clearance coordinator is responsible for ensuring BrightSpring clients have the correct demographic, subscriber, payer identified, authorization (as provided by operations), client out of pocket documented. 

Responsibilities:

This position will be responsible for including but not limited to:

* Admission into EHR/EMR for assigned lines of business.
* Insurance maintenance is current and accurate, as provided by operations.
* Insurance payer knowledge and accurate completion of IVQ
* Obtaining accurate benefit information as provided by payer.

* Identification of payer sources for our private pay or under-insured population
* Knowledgeable of programs in which BrightSpring participates.
* Hardship Programs
* Financial Assistance Programs
* Health Care Credit extension
* Ensures payment plan or program meets repayment guidelines set by BrightSpring Health Services Revenue Cycle policies.

* Ensures all CDEs(Critical Data Elements) are identified and entered correctly in EMR/HER (as applicable by line of business)
* Works closely with Operations Leaders and Revenue Cycle Leaders (specificity by line of business):
* Communicates with Revenue Cycle leaders and Operations leaders any anticipated issues or loss of revenue due to client inability to pay or loss of eligibility
* Understands and communicates SVP increases and decreases (applicable lines of business)

* While completing the IVQ, identifies client eligibility and insurance verification issues using various modes of identification:
* Way Star
* State Medicaid Website
* Commercial Payer Website
* Phone call to Payer

* Conduct financial conversations with clients to provide benefit explanations and analysis of deductibles, etc. to determine terms of payment for client liability within the parameters of corporate policy, when applicable.
* Ensures the playbook for Financial Clearance is accurate and up to date with all processes and programs.
* High knowledge level of commercial and government payers by line of business:
* Out of pocket client responsibility
* Contracted rates both in network and out of network
* Benefit level detail understanding of above rates

* Tied to the following Key Performance Indicator to maintain and improve revenue for the organization.
* Productivity standards completing 25 tickets/day (individual goal, depending on line of business)
* Quality standard of 95% or greater (individual goal)
* (Future in 2025) Rejection rate and resolution (individual goal)
* Ticket SLA violation goal of 99% or greater (team goal)

Qualifications:

* Bachelor's Degree or equivalent of school and experience, preferred.
* Medical terminology
* Financial Clearance and collection experience.
* Front Revenue Cycle experience either in Patient Access or Patient Financial Services.
* Proven experience with conflict resolution. 
* Ability to use critical thinking skills to identify and mitigate revenue risk to BrightSpring Health
* Self-directed work and excellent time management skills
* Excellent communication skills both verbal and written. 
* Knowledge of government and commercial payer requirements. 
* Ability to demonstrate our company Legacy standards. 
* Strong attention to detail and accuracy. 
* Strong time management skills and ability to meet set deadlines.
* Ability to multi-task and show flexibility as daily priorities arise and change.
* Minimum travel required.
			

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BrightSpring Health Services