Financial Clearance Representative III

Job Description
At TriHealth, our Financial Clearance Representatives play a critical role in ensuring every patient begins their care journey with clarity, compassion, and confidence. You are at the front line of financial advocacy—helping patients understand coverage, removing barriers to care, and contributing directly to a seamless, trusted healthcare experience.
Location: Work from home
Schedule: 8:30 AM- 5:00 PM, M-F
Incentives & Benefits
We offer competitive shift differentials, opportunities for professional growth, and a comprehensive benefits package that may include medical, dental, vision, paid time off, retirement savings plans, and tuition reimbursement.
PRN positions not eligible for TriHealth benefits
https://careers.trihealth.com/what-we-offer/benefits
Minimum Job Requirements
High School Degree in Medical terminology course or equivalent knowledge
Knowledge of Medical Terminology
Insurance vocabulary and processes
Government and Non-government third party benefits and coverage rules
Understanding of the impact financial clearance services has on revenue cycle operations and financial performance
1-2 years experience Customer Service Healthcare Dedication to treating both internal and external constituents as clients and customers Maintaining a flexible customer service approach and orientation that emphasizes service satisfaction and quality
Background in managed care or patient billing
1-2 years experience Technical Healthcare
Must have one year experience in insurance verification or precertification experience
Experience with automated patient account system or online verification systems
Job Overview
This position is responsible for verifying patient insurance, confirming benefits eligibility, performing authorization and pre-certification, calculating and estimating patient liability, and/or notification as required by third party coverage providers. Purpose of this job is to verify that TriHealth patient insurance information is accurate and up to date so payment will be received for services rendered. Additionally, this position requires the knowledge to review medical records obtaining information such as diagnosis, prior treatment, sign and symptoms, medication and other medical information to submit requests for authorizations for surgery, testing or treatment.
Working Conditions
Climbing - Rarely
Concentrating - Consistently
Continuous Learning - Frequently
Hearing: Conversation - Consistently
Hearing: Other Sounds - Rarely
Interpersonal Communication - Consistently
Kneeling - Rarely
Lifting <10 Lbs - Rarely
Lifting 50+ Lbs - Rarely
Lifting 11-50 Lbs - Rarely
Pulling - Rarely
Pushing - Rarely
Reaching - Occasionally
Reading - Consistently
Sitting - Frequently
Standing - Occasionally
Stooping - Occasionally
Talking - Consistently
Thinking/Reasoning - Consistently
Use of Hands - Consistently
Color Vision - Rarely
Visual Acuity: Far - Consistently
Visual Acuity: Near - Consistently
Walking - Frequently
TriHealth SERVE Standards and ALWAYS Behaviors
At TriHealth, We Believe There Is No Responsibility More Important Than To SERVE Our Patients, Our Communities, And Our Fellow Team Members. To Achieve Our Vision And Mission, ALL TriHealth Team Members Are Expected To Demonstrate And Live The Following
Serve: ALWAYS…
Welcome everyone by making eye contact, greeting with a smile, and saying "hello"
Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
Refrain from using cell phones for personal reasons in public spaces or patient care areas
Excel: ALWAYS…
Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met
Offer patients and guests priority when waiting (lines, elevators)
Work on improving quality, safety, and service
Respect: ALWAYS…
Respect cultural and spiritual differences and honor individual preferences.
Respect everyone’s opinion and contribution, regardless of title/role.
Speak positively about my team members and other departments in front of patients and guests.
Value: ALWAYS…
Value the time of others by striving to be on time, prepared and actively participating.
Pick up trash, ensuring the physical environment is clean and safe.
Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.
Engage: ALWAYS…
Acknowledge wins and frequently thank team members and others for contributions.
Show courtesy and compassion with customers, team members and the community

Work arrangement
Yes