Financial Clearance Representative

Sacramento, CA
Salary: $18.00 /hour



Position Summary:

Serves as the pre-service point of contact for patients to obtain all necessary information to pre-register and financially clear patients prior to day of service delivery.

Also handles non-clinical referrals and authorization coordination and unbilled account follow-up. Enhances the patient experience throughout all patient interactions by serving as the customer service point of contact by demonstrating knowledge of Sutter’s Health system and service offerings.

Supports the success of a high-performing shared services organization by helping to champion and drive the long-term Sutter Shared Services vision.

Helps foster an environment in which continuous improvement in business processes and services is welcomed and recognized.

Participates in programs and in using tools in support of building a high performance culture via the standard Sutter Shared Services responsibilities (e.g. performance measurement, people development, customer relationship management, etc.).


High School Diploma

Required AA/AS or equivalent experience and education is desired

Certified Healthcare Access Associate (CHAA) and/or Certified Patient Account Technician (CPAT) and/or Certified Revenue Cycle Representative (CRCR)

Top five principal accountabilities:

Assignment Specific Responsibilities

•Obtains and/or verifies demographic, clinical, financial, and insurance information in the process of pre-registering and financially clearing patients for service delivery, including the entry of patient/guarantor information in the patient registration/accounting systems

•Conducts insurance eligibility/benefit verification, referral/authorization, and financial education on designated accounts

•Performs activities that relate to pre-registration and financial clearance for multiple patient types (e.g. Inpatient Admissions, Diagnostic Outpatients, Ambulatory Surgery, Series accounts), and supports coverage of other departmental divisions; Frequent communications will occur with patients/family members/guarantors, and physicians/office staff in the deployment of key activities

•Notifies patient/guarantor of patient liabilities, collects such liabilities, and/or refers appropriate cases to Financial Counseling for follow-up and consultation

•Enhances the patient experience throughout all patient interactions, which will be telephone based, demonstrating knowledge of Sutter’s Health system and service offerings

•Authenticates patient identity throughout all essential functions

•Provides logistics and way finding information

•Performs revenue cycle tasks necessary to ensure compliance, and exceptional customer service

•Maintains knowledge of applicable Federal, State, and local laws and regulations, Standards of Conduct, as well as Sutter policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior

•In initial year, participates in cross-training and job enlargement opportunities for Major job responsibilities. Works with direct supervisor to identify minor set of responsibilities to develop and perform in support of peaks, valleys and cycles across Sutter Shared Services and individual career growth opportunities. Performs both Major and Minor responsibilities after initial year. 60%Continuous Improvement

•Supports the implementation of programs, policies, initiatives, and tools specific to Sutter Shared Services processes owned by Patient Access across the organization

•Contributes ideas and actions towards the continuous improvement of Patient Access related processes within area of influence 10%Performance Management

•Ensures delivery of business results by meeting or exceeding all individual operating metrics

•Plans and organizes work so Individual Operating Metrics and Service Level Agreement objectives are realized

•Recognizes and communicates potential issues to team leader as appropriate 10%

People Development

•Adapts to learning new processes, concepts, and skills

•Seeks and responds to regular performance feedback from team lead; provides upward feedback as needed 10%

Relationship Management

•Maintains positive work relationships with members of other teams in Sutter Shared Services to communicate effectively and to ensure compliance with cross-team responsibilities•Assists in ensuring efforts of the Patient Access Center Team support building strong peer-to-peer relationships 10%


•Experience within a hospital or clinic environment, an insurance company, managed care organization or other financial service setting, performing financial counseling, financial clearance and/or customer service activities as typically acquired in two years

•Completion of regulatory/mandatory certifications and skills validation competencies preferred


•General knowledge of patient access financial counseling functions in acute and non-acute settings preferred

•Working knowledge of medical terminology desired

•Working knowledge and understanding of insurance terminology desired

•Working knowledge of applicable Federal, State, and local laws and regulations desired


•Excellent time management skills and the ability to manage frequent telephone patient contacts while effective maintaining and documenting data in the patient registration systems

•Ability to utilize multiple modes of communication (e.g. phone, fax, patient portal, e-mail, physician portal, mail, etc.) in a professional, accurate, efficient and courteous manner

•Demonstrated ability to work in multiple computer systems, such as patient registration/accounting systems, document imaging, scanning, payment posting, proprietary payer websites and data quality monitoring, both accurately and efficiently

•Strong data entry skills required

Excellent verbal and written communication and active listening skills

•Interpersonal skills necessary in dealing with internal and external customers

•Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Sutter Health

•Accuracy and attentiveness to detail required

•Must be able to set and organize own work priorities, and adapt to change

•Must be able to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals havin g diverse personalities and work styles

•Ability to meet or exceed targeted customer service, productivity and quality standards

•Fluency in both English and a minimum of one other language is preferred for this role to allow Sutter Health to better serve the community and patient population

•Requires the ability to work with and maintain confidential information






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