Schedule: Monday-Friday 8:00am to 4:30pm

Something special starts here.

You can’t define it, but you know it when you see it: the difference between an average life and the good life. When your cup is full – with joy, purpose and lifelong health – it shows. At LMH Health, we are all about healthy people, healthy communities and healthy futures, and that makes us your destination for an exceptional career. From flexible, work-life harmony to competitive pay and great advancement potential, find everything you’re looking for at LMH Health.

You'll find everything you’re looking for at LMH Health:

·            Join a team that cares about the community

·            Tuition reimbursement to support continuing education

·            Professional development and recognition

·            Excellent benefits

We’re looking for you.

The Central Financial Clearance (CFC) Lead performs day to day follow up activity for patient estimates, insurance eligibility, authorizations, and pre-registrations for all hospital based services. This role includes providing education and direction to peers to promote a satisfactory patient experience beyond the clinician interaction.

Responsibilities

1.       Ensure insurance eligibility, authorizations, estimations and pre-registrations are obtained, completed, and delivered on scheduled hospital based procedures prior to their arrival for service, provided they are placed on the schedule at least 24 hours in advance of the procedure.

2.       Serve as the first point of contact for day to day issues, works with the CFC Manager for resolution as needed and to improve processes going forward.

3.       Address eligibility issues as they arise by coordinating with CFC staff, Patient Access Management team, the patient and applicable scheduling department.
- Help coordinate staff education to address gaps in eligibility/insurance knowledge.

4.       Responsible for ensuring the timely completion of authorizations/financial clearance on hospital based services.
- Maintain a working knowledge of coverage policies, benefits and procedure codes.
- Documents concisely and accurately all communication with insurance companies, ordering providers, registration staff, ancillary departments and the patient related to the scheduled service.

5.       Working knowledge of the No Surprises Act and Good Faith Estimates expectations and processes to ensure compliance. Report any issues or concerns to CFC Manager for their resolution.

6.       Performs and documents insurance eligibility, estimations and pre-registrations in accordance with LMH CFC processes and procedures.

7.       Develop workflows to address unnecessary claim denials and work with CFC Manager or designee to implement and follow up on process improvements.

8.       Performs at a high level with little supervision.

9.       Demonstrates excellent inter-personal skills, strong attention to detail, multi-task oriented.

10.     Performs special projects and other duties as assigned.

Qualifications

Required:

1. High school diploma or equivalent.
2. Two years prior healthcare setting work experience.

Our Cultural Beliefs

• People First 
• Integrity Matters
• Better Together

At LMH Health, we value inclusion and diversity. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.