Financial Clearance Coordinator – PFS-PASC-Authorization (1.0 FTE, Days)

Patient Services

1.0 FTE, 8 Hour Day Shift

At Stanford Children’s Health, we know world-renowned care begins with world-class caring. Thats why we combine advanced technologies and breakthrough discoveries with family-centered care. Its why we provide our caregivers with continuing education and state-of-the-art facilities, like the newly remodeled Lucile Packard Childrens Hospital Stanford. And its why we need caring, committed people on our team – like you. Join us on our mission to heal humanity, one child and family at a time.

Job Summary

This paragraph summarizes the general nature, level and purpose of the job.

The Financial Clearance Coordinator is responsible for managing patient registration and insurance-related tasks. This includes identifying a patient’s insurance coverage or financial resources for covering medical care, verifying insurance benefits, and providing auto-generated cost estimates. They also assist patients with questions about insurance benefits and specific payor requirements, while addressing routine customer service inquiries and issues. Additionally, the coordinator ensures the completion of necessary admission and registration processes and secures required documentation for billing and compliance purposes.

Essential Functions

The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned.

Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patient rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings.

Must perform all duties and responsibilities in accordance with the hospital’s policies and procedures, including its Service Standards and its Code of Conduct.

Act as a registration expert and liaison between the practice operations, and the patient financial advocates.

Serves as point of contact for addressing registration and insurance issues, patient concerns and billing insurance questions to the extent possible before escalating to other financial advocate departments (billing, financial counselors).

Explain financial obligations, billing process, and collecting payment or establishing payment arrangements with the patients as necessary for the planned treatment and/or procedures (includes, but not limited to; obtaining coverage and updating registration, verifying covered/non-covered service, creating estimates, etc.

Assures secure handling and accurate recording of payments collected prior to scheduled visit – responsible for cash collection protocols.

Responsible for Cost Estimate protocols automated through EPIC EMR system.

Maintains professional communication with various staff, physicians, and patients regarding the financial clearance services. Communication will consist of telephone, email, EMR system correspondence.

Effectively determines primary, secondary, and tertiary liability by coordination of payer plan benefits including government and commercial payor plans.

Communicates liabilities directly to patients and provides estimates and education on key insurance terms and rules; may often handle patients with more complicated insurance plans (e.g., Medicaid, self-pay, and inactive plans)

Documents financial clearance process and discussions in the EMR

Connect patients to Financial Counselors in obtaining financial assistance (i.e. FAA, self-pay) – referrals to appropriate resource departments for program enrollment, and/or assists patients to fill out forms as necessary.

Connects patients with financial counselors when further explanation or education is needed regarding payment plans and complete financial assistance, including, but not limited to, all necessary forms, resources, payments, and submissions.

Cross trains and responsible for financial clearance, with the potential for service line rescheduling workflows in coordination with clinical scheduling requirements and protocols.

Maintains the assigned daily volumes while meeting productivity requirements.

Manages communication via In-basket messages, emails, and other methods for completeness and accuracy of information needed to fulfill financial clearance requirements.

Reviews and updates member registration including processing real time payor eligibility for membership eligibility.

Other tasks/duties, as assigned.

Minimum Qualifications

Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.

Education: High school diploma or GED equivalent

Experience: Two (2) years of progressively responsible and directly related work experience.

Licensure/Certification: None required.

Knowledge, Skills, & Abilities

These are the observable and measurable attributes and skills required to perform successfully the essential functions of the job and are generally demonstrated through qualifying experience, education, or licensure/certification.

Ability to analyze operational and procedural problems and develop, recommend and evaluate proposed solutions.

Ability to speak and write effectively at a level appropriate for the job.

Ability to work well with individuals at all levels of the organization.

Knowledge of computer systems and software used in functional area.

Knowledge of Medical Terminology.

Knowledge of Medicare, Medi-Cal, Workers Comp, Managed Care (HMO, PPO, POS, etc ), Childrens Health Programs (CCS, GHPP, Healthy Families, etc ).

Physical Requirements and Working Conditions

The Physical Requirements and Working Conditions in which the job is typically performed are available from the Occupational Health Department. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions of the job.

Pay Range

Compensation is based on the level and requirements of the role.

Salary within our ranges may also be determined by your education, experience, knowledge, skills, location, and abilities, as required by the role, as well as internal equity and alignment with market data.

Typically, new team members join at the minimum to mid salary range.

Minimum to Midpoint Range (1.0 FTE): $ to $

Equal Opportunity Employer

L ucile Packard Children’s Hospital Stanford strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, LPCH does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements, and where applicable, in compliance with the San Francisco Fair Chance Ordinance. REQNUMBER: 20140-1A