Financial Clearance Representative Lead

Opportunities at Optum, in strategic partnership with Allina Health. As an Optum employee, you will provide support to the Allina Health account. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Financial Clearance Representative Lead is responsible for completing the financial clearance process and creating the first impression of Allina's services to patients, their families, and other external customers. Must be able to articulate information in a manner that patients, guarantors, and family members understand and will know what to expect regarding their financial responsibilities. Works with medical staff, nursing, ancillary departments, insurance payers, and other external sources to assist families in obtaining healthcare and financial services. Functions as a subject matter expert for the department. Coaches and mentors are experienced staff on all aspects of financial clearance.

You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Perform financial clearance processes by interviewing patients and collecting and recording all necessary information for pre-registration of patients
• Educate patients of pertinent policies as necessary i.e., Patient Rights, HIPAA information, consents for treatment, visiting hours, etc.
• Verify insurance eligibility and completes automated insurance eligibility verification, when applicable and appropriately documents information in Epic
• Confirm that a patient's health insurance(s) is active and covers the patient's procedure
• Confirm what benefits of a patient's upcoming visit/stay are covered by the patient's insurance(s) including exact coverage, effective date of the policy, coverage limitations / requirements, and patient liabilities for the type of service(s) provided
• Provide proactive price estimates and work with patients so they understand their financial responsibilities
• Inform families with inadequate insurance coverage of financial assistance through government and financial assistance programs and refers the patient to financial counseling
• Review and analyze patient visit information to determine whether authorization is needed and understands payor specific criteria to appropriately secure authorization and clear the account prior to service where possible
• Ensure that initial and all subsequent authorizations are obtained in a timely manner
• Provide mentoring and daily workflow coaching to less experienced team members on all aspects of the revenue cycle, payer issues, policy issues, or anything that impacts their role

 Performs Enhanced Financial Clearance activities:

• May complete admission reviews for hospital admissions to support the authorization process
• May complete notification of hospital admission and discharge for hospital admissions
• Expanded insurance benefit review for more complex and/or high dollar procedures
• Perform financial counseling with patients; includes evaluating assistance programs the patient may qualify for, completing applications, determining the need for delay/cancel of services and escalating as needed
• May be assigned to work special projects and/or non-standard workflows

Organize and coordinate Financial Clearance team activities:

• Provide day-to-day work assignments, oversight and leadership to staff
• Work with the department Supervisor to set standards, develop and execute improvement plans
• Alert Supervisor of any backlogs and provides suggestions for resolution
• Communicate issues that need management attention and/or identifies areas where staff, process, or performance improvements are needed to Supervisor
• Review and resolve accounts that are complex and require a higher degree of expertise and critical thinking
• Participate in the orientation and training of employees and provides feedback to leadership
• Perform daily accuracy reports and quality assurance reviews of patient accounts as directed
• May act as a back-up for work within the department
• Other duties as assigned 

What are the reasons to consider working for UnitedHealth Group?   Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 4+ years of experience with Insurance and/or Benefit Verification activities in healthcare business office/insurance operations
• 1+ years of experience as a Financial Clearance Representative 
• Ability to work Monday - Friday - 7 AM - 3:30 PM CST
• Must be 18 years of age OR older

Preferred Qualifications:

• Associate's or Vocational degree in Business Administration, Health Care Administration, Public Health, or Related Field of Study
• Experience working with clinical staff
• Previous experience working in outpatient and/or inpatient healthcare settings
• Experience working in clinical documentation
• Previous experience working with a patient's clinical medical record

Soft Skills: 

• Excellent customer service skills
• Excellent written and verbal communication skills
• Demonstrated ability to work in fast paced environments 

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $36.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO, #GREEN