Eligibility and Financial Clearance Team Lead

Gaithersburg, MD
Jan 31, 2019
Mar 28, 2019
Full Time
Support Center

If you are a current Adventist HealthCare employee, please click this link to apply through your Workday account. Adventist HealthCare seeks to hire people who will embrace our mission to extend God's care through the ministry of physical, mental and spiritual healing. As a faith-based organization with over a century of caring for the communities in the Maryland area, Adventist HealthCare has earned a reputation for high-quality, compassionate care. Adventist HealthCare was the first and is the largest healthcare provider in Montgomery County.

The Eligibility and Financial Clearance Team Lead is responsible for ownership of patient financial obligations for inpatient and select outpatient encounters. The Eligibility and Financial Clearance Team Lead confirms insurance coverage and eligibility, obtains authorizations for service, identifies other sources of payment for uninsured patients, and assists in referrals.

* Acts as lead in providing escalation oversight for the patient financial process
* Independently problem solves and identifies opportunities for improvement. Working with management to develop new financial policies where appropriate
* Communicate clearly to patient or patient designee, insurance coverage/benefits, patient financial obligations, and impact of unpaid services
* Provide feedback to Patient Financial Advisors.
* Ensure compliance of all policies and procedures by staff.
* Acts as thought partner for financial policies and procedures as they relate to coverage verifications, authorizations, financial options, and AHC financial assistance

* High School Graduate with some college experience
* Minimum of 3 years of experience within a healthcare financial environment, which can include insurer or public health setting.
* Minimum of 1 years of experience establishing eligibility and/or payment authorizations.
* Strong knowledge and training in government rules and regulations, including TPLs, WC, and other payment sources and liabilities.
* Requires knowledge of MD state regulations, 501R, payment, billing, and adjudication processes
* Knowledge and utilization of Windows desktop applications including Word and Excel.
Work Schedule:

Full Time Days, Monday through Friday.

At Adventist HealthCare our job is to care for you. We do this by offering:
* Recognition and rewards for professional expertise
* Free Employee parking
* Competitive comprehensive benefit plans offered (including health, disability, PTO and 403-B retirement plan with matching and 3 year vesting)
* 100% Coverage for inpatient care - at Adventist HealthCare facilities
* 100% Coverage for urgent care nationwide - after copay

If you want to make a difference in someone's life every day, consider a position with a team of professionals who are doing just that, making a difference. Join the Adventist Healthcare team today! Apply now to be considered.

Tobacco Statement

Tobacco use is a well-recognized preventable cause of death in the United States and an important public health issue. In order to promote and maintain a healthy work environment, Adventist HealthCare will not hire applicants for employment who either state that they are nicotine users or who test positive for nicotine use.

Adventist HealthCare will withdraw offers of employment to applicants who test positive for Cotinine (nicotine). Those testing positive for cotinine are given the opportunity to re-apply in 90 days, if they can truthfully attest that they have not used any nicotine products in the past ninety (90) days and successfully pass follow-up testing.

Equal Employment Opportunity

Adventist HealthCare is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.

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