Financial Clearance Representative

Management Consulting | Core Business Operations

Chicago, Illinois, United States

Position Summary

Are you an experienced, passionate pioneer in technology? An industry solutions professional who wants to work in a collaborative environment. As an experienced Financial Clearance Representative you will have the ability to share new ideas and collaborate on projects as a consultant without the extensive demands of travel. If so, consider an opportunity with Deloitte under our Project Delivery Talent Model. Project Delivery Model (PDM) is a talent model that is tailored specifically for long-term, onsite client service delivery.  PDM practitioners are local to project locations, minimizing extensive travel, and provides you with a full career path within the firm.

Work you’ll do/Responsibilities  

Join our high performing Patient Access team in delivering pre-service financial clearance activities for a large regional health system. Financial Clearance representatives will work as a combined US-based and India-based team to complete key pre-service financial clearance activities which include verifying health insurance eligibility and benefits, generating price estimates and obtaining prior authorizations.

Responsible for completing the financial clearance process, including:

  • Verify insurance eligibility and benefits for patients' upcoming services and appropriately document information in Epic
  • Confirm that a patient’s health insurance(s) is active and covers the patient’s procedure
  • Confirm which 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
  • Generate proactive price estimates
  • 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
  • May provide mentoring to less experienced team members on all aspects of the revenue cycle, payer issues, policy issues, or anything that impacts their role
  • Other duties as assigned
  • Captures important lessons and shares them to foster innovation
  • Empower, coach and encourage others to be at their best selves
  • Take ownership of outcomes and fulfillment of goals
  • Respect others’ opinions, praise good work and encourage all team members to be involved

The Team 

Our Core Technology Operations (CTO) team offers differentiated operate services for our clients with solutions to help organizations scale and optimize critical business operations, drive speed to outcome, deliver business transformation, and build resilience in an uncertain future.

Our operate services within CTO include:

  • Foundry Services: Operate services providing flexible, recurring resource capacity for client initiatives, projects, tasks, and enhancement
  • Managed Services: Operate services that provide ongoing maintenance, monitoring, and optimization for IT/Engineering applications & products

Qualifications

Required

  • High School Diploma
  • 2 years’ experience with hospital outpatient insurance and benefit verification, pre-registration and/or prior authorization activities for mid to large health system
  • Comfortable working in fast-paced environments, is adaptable and flexible to everyday tasks
  • Can navigate through multiple screens to provide the essential information needed to complete an encounter
  • Computer literacy, ability to navigate through screens
  • Familiarity with complex or multi-line phone systems
  • Experience exceeding productivity, quality and service targets
  • Utilizes critical thinking to solve problems
  • Team player
  • Limited immigration sponsorship may be available
  • Ability to travel 10%, on average, based on the work you do and the clients and industries/sectors you serve

Our people and culture

Our diverse, equitable, and inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our client most complex challenges. This makes Deloitte one of the most rewarding places to work. Learn more about our inclusive culture.

Professional development

From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career.


As used in this posting, "Deloitte" means Deloitte Consulting LLP, a subsidiary of Deloitte LLP. Please see www.deloitte.com/us/about for a detailed description of the legal structure of Deloitte LLP and its subsidiaries.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law.

Requisition code: 119308

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