Specialist Financial Clearance II - Prior Authorization - Remote Mount Carmel East

Employment Type: Full timeShift: Day Shift Description: At Mount Carmel, we work to continuously inspire one another. Here, all are welcome. It is this culture of humility and compassion that sets Mount Carmel apart. We see the big picture and do the right thing. That means a dedication to the well-being our both our colleagues and the patients they serve. Position Purpose: • Uses specialized knowledge to support key areas of the organization related to an area of expertise. Obtain prior authorization. Working with physicians, insurance companies and patients to work with prior authorization. • Location: Remote • Hours of office: Flex hours between 7:30am – 6:00pm What You Will Do: 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: Research & 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 in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices. Minimum Qualifications: • 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. • Must possess a comprehensive knowledge of financial clearance and insurance verification processes with two (2) years of financial clearance experience in an acute care setting. Position Highlights and Benefits: • Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one. • Retirement savings account with employer match starting on day one. • Generous paid time off programs. • Employee recognition programs. • Tuition/professional development reimbursement. • Relocation assistance (geographic and position restrictions apply). • Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing. • Employee Referral Rewards program. • Mount Carmel offers DailyPay - if you’re hired as an eligible colleague, you’ll be able to see how much you’ve made every day and transfer your money any time before payday. You deserve to get paid every day! • Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups. Ministry/Facility Information: Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our four hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohios largest undergraduate, graduate, and doctor of nursing programs. If you’re seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You! 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. Apply tot his job