Payor Clearance Specialist

Children's National
Silver Spring, MD
Category Healthcare
Job Description
Payor Clearance Specialists facilitate patient access into the care continuum by navigating insurance payor regulations, decrease payor related barriers, and increase financial outcomes for scheduled patient services.

Requirements

  • High School Diploma or GED
  • 3 years Healthcare experience with payor navigation, claims and billing, healthcare registration, insurance referral and authorization processes insurance authorizations, and appeals
  • 2 years Experience related to CPT and ICD coding assignment
  • Ability to communicate with physicians’ offices, patients and insurance carriers in a professional and courteous manner
  • Superior customer service skills and professional etiquette
  • Strong verbal, interpersonal, and telephone skills
  • Experience in healthcare setting and computer knowledge necessary
  • Attention to detail and ability to multi-task in complex situations
  • Demonstrated ability to solve problems independently or as part of a team
  • Knowledge of and compliance with confidentiality guidelines and CNMC policies and procedures
  • Knowledge of insurance requirements and guidelines for Governmental and non-Governmental carriers
  • Previous experience with Cerner, Passport, or other related software programs and EMRs preferred
  • Bilingual abilities preferred
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