Patient Financial Clearance Representative

VCU Health

. Perform the full scope of financial clearance activities for assigned patients before scheduled appointments .

Posted 10/30/2026full-timeRemote • United StatesMid-LevelSenior💰 $18 - $26 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in financial clearance activities, insurance eligibility verification, and patient registration processes within healthcare settings. Proficient in managing patient financial responsibilities and coordinating with healthcare providers and insurance plans.

Highest-signal resume keywords

Insurance Plan AuthorizationPatient RegistrationCommercial Health InsuranceManaged Care ExperienceMedical Billing

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Financial Clearance ActivitiesInsurance Eligibility VerificationPCP ReferralsOut-of-Pocket Liability CalculationICD CodingCPT CodingMedical TerminologyThird-Party Payer Payment ProcessingPatient Account ManagementReferral Requirements

Soft Skills

Customer Service SkillsProblem SolvingLogical ThinkingAttention to DetailCommunication Skills

Tools & Technologies

GE-IDX Patient RegistrationMicrosoft OfficeWeb-Based ToolsEmail Applications

Industry Keywords

Healthcare SettingManaged CareGovernmental Health Care PlansAuthorization RequirementsPatient Financial Responsibility

About the role

Key responsibilities & impact

Perform the full scope of financial clearance activities for assigned patients before scheduled appointments
Confirm completeness of patient registration data
Verify insurance eligibility and health plan benefits using multiple systems, web-based tools, and calls to payers and patients
Procure PCP referrals and health plan authorizations
Calculate out-of-pocket liability and collect deposits, co-pays, deductibles, and outstanding balances before service
Communicate patient financial responsibility clearly and transparently
Restrict or redirect out-of-network patients
Refer patients to financial counselors when assistance is needed with alternate payer sources or payment plans
Contact primary care physicians to secure PCP referrals
Contact health plans to secure prior authorizations
Coordinate peer-to-peer reviews between VCUHS physicians and health plan medical directors
Prepare forms required to obtain third-party payer payment
Determine when to apply additions or revisions to patient accounts and current visits
Maintain knowledge of commercial, managed care, governmental health care plans, and authorization/referral requirements

Requirements

What you’ll need

Minimum three (3) years of previous experience in a health care setting
Experience in commercial, managed care and governmental health insurance plans
One (1) year experience in insurance plan authorization and referral requirements; or Medical billing
Previous experience using a personal computer and various software applications, including Microsoft, e-mail, etc.
Strong customer service skills and patient/customer-centered focus
High School Diploma or equivalent
No licensure, certification, or registration required for hire or continued employment
May require work hours to periodically extend to 8:00 p.m. as necessary to resolve backlog or contact patients for registration data
Ability to lift 20–50 lbs.
Ability to perform prolonged sitting, reaching, repetitive motion, and prolonged PC/keyboard usage
Strong recall, reasoning, problem solving, hearing, clear speech, legible writing, reading, logical thinking, and concentration/focus
Ability to work in a fast-paced environment, handle multiple priorities, frequent and intense customer interactions, noisy environments, and frequent change
Previous experience using GE-IDX Patient Registration or another medical billing/registration system preferred
Previous experience in ICD and CPT coding preferred
Previous experience using medical terminology preferred
Post high school education in healthcare or medical billing coursework preferred