Sr Patient Coordinator - SME

The Subject Matter Expert - Financial Clearance serves as the primary process expert for Financial Clearance operations, providing advanced support in insurance verification, benefits investigation, prior authorization, and patient access activities. This role is responsible for resolving complex cases and escalations, ensuring quality and compliance, and driving operational excellence through training, mentoring, audits, and process improvement initiatives. The SME partners with cross-functional teams to enhance revenue cycle performance, optimize patient financial clearance processes, and support a seamless patient experience.

Qualifications

Required Experience

• Minimum 3 years of Healthcare Revenue Cycle Management (RCM) experience.

• Minimum 2 years of experience in one or more of the following areas:

  • Financial Clearance
  • Insurance Verification
  • Prior Authorization
  • Patient Access

Required Knowledge & Skills

• Strong understanding of:

  • Insurance Verification
  • Benefits Investigation
  • Prior Authorization
  • Medical Necessity Requirements
  • Financial Clearance Processes

• Experience working with EMR/EHR systems such as:

  • Epic
  • Cerner
  • Meditech
  • Or similar healthcare platforms

• Strong analytical and problem-solving skills.

• Excellent verbal and written communication skills.

• Proven ability to train, mentor, and support operational teams.

• Ability to manage escalations and make sound decisions in a fast-paced healthcare environment.