Saint Joseph Mercy Health System
Specialist, Financial Clearance II
Saint Joseph Mercy Health System, Ypsilanti, Michigan, United States, 48197
Specialist, Financial Clearance II – Saint Joseph Mercy Health System
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Employment Type Full time
Shift Day Shift
Description Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem‑solving skills to support colleagues & leadership in achieving organization’s strategic objectives. Serves as a peer influencer and may direct a project or project team by applying industry experience & specialized knowledge.
Essential Functions
Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions.
Work focus: researches, collects & analyzes information; identifies opportunities, develops solutions, & leads through resolution.
Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience.
Responsible for distribution of analytical reports.
Process focus: utilizes multiple system applications to perform analysis, create reports & develop educational materials; incorporates basic knowledge of Trinity Health policies, practices & processes to ensure quality, confidentiality & safety are prioritized.
Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge.
Data Management & Analysis: researches & compiles information to support ad‑hoc operational projects & initiatives; synthesizes & analyzes data & provides detailed summaries including graphical data presentations illustrating trends & recommending practical options or solutions while considering the impact on business strategy & supporting leadership decision making.
Leverages program & operational data & measurements to define & demonstrate progress, ROI & impacts.
Maintains a working knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices.
Specialist II: experienced in processing financial clearance for complex services including surgical services, observation, and in‑house cases.
Minimum of five (5) years of financial clearance / authorization experience in an acute care setting.
Experienced in complex facility‑based ancillary testing across multiple facilities/states.
Responsible for complex, high‑dollar services including surgical, observation and in‑house services working in multiple areas of verification including outpatient verification, elective short procedure / inpatient verification, & urgent admission verification or scheduling.
Minimum Qualifications
High School Diploma or equivalent.
Two (2) to Five (5) years' experience in area of expertise such as scheduling, financial clearance, or patient access.
National certification in HFMA CRCR or NAHAM CHAA required within one (1) year of hire.
Must be proficient in the use of Patient Registration/Patient Accounting systems and related software systems.
Additional Qualifications (Nice to Have)
Associate's degree, preferred.
Comprehensive knowledge of scheduling with mastery in at least three (3) modalities and insurance verification processes with three (3) years scheduling experience in an acute care setting.
Experience in complex facility‑based ancillary testing across multiple facilities/states.
Strong knowledge of third‑party and government payer billing and reimbursement guidelines as well as department performance standards and policies and procedures.
Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person‑centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Job ID: 00627155
#J-18808-Ljbffr
Employment Type Full time
Shift Day Shift
Description Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem‑solving skills to support colleagues & leadership in achieving organization’s strategic objectives. Serves as a peer influencer and may direct a project or project team by applying industry experience & specialized knowledge.
Essential Functions
Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions.
Work focus: researches, collects & analyzes information; identifies opportunities, develops solutions, & leads through resolution.
Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience.
Responsible for distribution of analytical reports.
Process focus: utilizes multiple system applications to perform analysis, create reports & develop educational materials; incorporates basic knowledge of Trinity Health policies, practices & processes to ensure quality, confidentiality & safety are prioritized.
Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge.
Data Management & Analysis: researches & compiles information to support ad‑hoc operational projects & initiatives; synthesizes & analyzes data & provides detailed summaries including graphical data presentations illustrating trends & recommending practical options or solutions while considering the impact on business strategy & supporting leadership decision making.
Leverages program & operational data & measurements to define & demonstrate progress, ROI & impacts.
Maintains a working knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices.
Specialist II: experienced in processing financial clearance for complex services including surgical services, observation, and in‑house cases.
Minimum of five (5) years of financial clearance / authorization experience in an acute care setting.
Experienced in complex facility‑based ancillary testing across multiple facilities/states.
Responsible for complex, high‑dollar services including surgical, observation and in‑house services working in multiple areas of verification including outpatient verification, elective short procedure / inpatient verification, & urgent admission verification or scheduling.
Minimum Qualifications
High School Diploma or equivalent.
Two (2) to Five (5) years' experience in area of expertise such as scheduling, financial clearance, or patient access.
National certification in HFMA CRCR or NAHAM CHAA required within one (1) year of hire.
Must be proficient in the use of Patient Registration/Patient Accounting systems and related software systems.
Additional Qualifications (Nice to Have)
Associate's degree, preferred.
Comprehensive knowledge of scheduling with mastery in at least three (3) modalities and insurance verification processes with three (3) years scheduling experience in an acute care setting.
Experience in complex facility‑based ancillary testing across multiple facilities/states.
Strong knowledge of third‑party and government payer billing and reimbursement guidelines as well as department performance standards and policies and procedures.
Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person‑centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Job ID: 00627155
#J-18808-Ljbffr