Financial Clearance Specialist II

Fred Hutchinson Cancer Center is an independent, nonprofit organization providing adult cancer treatment and groundbreaking research focused on cancer and infectious diseases. Based in Seattle, Fred Hutch is the only National Cancer Institute-designated cancer center in Washington.

With a track record of global leadership in bone marrow transplantation, HIV/AIDS prevention, immunotherapy and COVID-19 vaccines, Fred Hutch has earned a reputation as one of the world's leading cancer, infectious disease and biomedical research centers. Fred Hutch operates eight clinical care sites that provide medical oncology, infusion, radiation, proton therapy and related services, and network affiliations with hospitals in five states. Together, our fully integrated research and clinical care teams seek to discover new cures to the world's deadliest diseases and make life beyond cancer a reality.

At Fred Hutch we value collaboration, compassion, determination, excellence, innovation, integrity and respect. These values are grounded in and expressed through the principles of diversity, equity and inclusion. Our mission is directly tied to the humanity, dignity and inherent value of each employee, patient, community member and supporter. Our commitment to learning across our differences and similarities make us stronger. We seek employees who bring different and innovative ways of seeing the world and solving problems. Fred Hutch is in pursuit of becoming an anti-racist organization. We are committed to ensuring that all candidates hired share our commitment to diversity, anti-racism and inclusion.

The Financial Clearance Specialist II is an intermediate level position within the Financial Clearance team of The Fred Hutch Cancer Center. This role is responsible for ensuring patients are financially cleared for intermediate procedures and non-complex drugs (in addition to all services covered within the scope of the Specialist I responsibilities) prior to receiving care by verifying insurance eligibility, confirming benefits, obtaining necessary authorization, and identifying out-of-pocket costs. The Financial Clearance Specialist II collaborates with patients, insurance providers, and clinical staff to provide excellent service while maintaining accuracy and compliance with payer and organizational policies. The role serves as a primary point of contact for patients regarding financial inquiries and requires attention to detail to ensure accurate and timely processing of pre-service tasks in accordance with payer requirements and the FHCC delay/defer policy. The Specialist is required to comply with government regulations (i.e. EMTALA and HIPAA) as it pertains to all financial clearance processes. In addition, this role is required to maintain professional development by attending workshops, in-services, and webinars to ensure adherence to updated insurance rules/regulations and changes within the healthcare industry.

Insurance Verification: Confirm patients' insurance coverage and eligibility using payer portals, clearinghouses, or by contacting payers directly.
• Benefit Validation: Validate specific plan benefits such as deductibles, copayments, and out-of-pocket maximums, to determine patient financial responsibility.
• Documentation: Accurately document insurance details, coverage limitations, and benefit confirmations in the patient's record or financial clearance system.
• Pre-Registration: Assist with gathering and verifying patient demographic information and updating records as needed.
• Patient Communication: Contact patients to explain benefits, notify them of out-of-pocket costs, and address any concerns or questions regarding financial responsibility.
• Denial Prevention: Identify potential financial barriers (i.e., lack of coverage or invalid insurance information) and proactively escalate issues to Financial Clearance Specialist Lead.
• Compliance: Adhere to organizational policies, payer regulations, and state/federal requirements to ensure compliance with all financial clearance activities.
• Collaboration: Work closely with scheduling, financial counseling, and prior authorization teams to resolve discrepancies and ensure patient readiness for treatment.

Required:

• High School Diploma or equivalent.
• 2+ years of relevant front-end revenue cycle experience (preregistration, prior authorization, patient interaction)
• Intermediate level knowledge of different payer types, medical terminology, CPT codes, and interpretation of patient liability and benefits.
• Intermediate level understanding of health insurance concepts, including deductibles, co-payments, coinsurance, and prior authorizations.
• Familiarity with health care terminology and general revenue cycle functions.
• Familiarity with generic drug names along with their basic indication is preferred, but not required.

Preferred:

• Associate/bachelor's degree in business, healthcare administration, or a related field
• Ability to work in a fast-paced environment while managing multiple tasks simultaneously.
• Capability to learn and adapt to new systems, payer portals, and workflows quickly.
• Problem-solving skills to identify and resolve financial clearance issues within the scope of Level II responsibilities.
• Ability to perform basic pharmaceutical calculations is preferred, but not required.

The hourly pay range for this position is from $25.72 to $36.62 and pay offered will be based on experience and qualifications.

This position is not eligible for immigration sponsorship. Applicants must already be authorized to work in the US and not require sponsorship now or in the future.

Fred Hutchinson Cancer Center offers employees a comprehensive benefits package designed to enhance health, well-being, and financial security. Benefits include medical/vision, dental, flexible spending accounts, life, disability, retirement, family life support, employee assistance program, onsite health clinic, tuition reimbursement, paid vacation (12-22 days per year), paid sick leave (12-25 days per year), paid holidays (13 days per year), paid parental leave (up to 4 weeks).