R

Roswell Park Comprehensive Cancer Center

Comprehensive cancer research and treatment center

Financial Clearance Representative 1/2

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours
Full-timeBuffalo, NY, USA$44.6k - $49.8k /yrIn-person

About the Job

Requirements

  • Experience working with insurance verification, authorizations, patient access, revenue cycle, healthcare administration, or a related healthcare setting.
  • Knowledge of medical insurance plans, payer requirements, and pre-authorization processes.
  • Ability to solve problems and think critically.
  • Ability to communicate with patients, insurance companies, and healthcare professionals and provide customer service.
  • Ability to manage multiple priorities while maintaining accuracy and attention to detail.
  • Comfort working with electronic systems, documentation, and reporting tools.
  • Ability to build working relationships across departments.
  • For Financial Clearance Representative I, a high school diploma or high school equivalency diploma and one year of full-time experience in pre-certifications and follow-up procedures or a related field, or successful completion of a Patient Access Representative traineeship at Roswell Park Comprehensive Cancer Center.
  • For Financial Clearance Representative II, a high school diploma or high school equivalency diploma and three years of full-time experience in authorization and follow-up procedures or a related field, or two years of full-time experience in Financial Clearance and/or Patient Access within Roswell Park's Financial Clearance Department.
  • Degrees must be conferred by an accredited school, college, or university, or by an institution recognized by Roswell Park Comprehensive Cancer Center and/or Health Research Incorporated as adhering to acceptable educational standards.

Responsibilities

  • Verify insurance coverage and benefits for new and existing patients.
  • Ensure patient demographic, insurance, and provider information is accurate and up to date.
  • Obtain required referrals, pre-certifications, and authorizations for services and treatments.
  • Communicate with insurance companies to support timely approvals and coverage determinations.
  • Serve as a resource for clinical teams regarding insurance and authorization requirements.
  • Investigate and resolve coverage issues that may impact patient care or billing.
  • Research denied services and assist with appeals and follow-up activities.
  • Coordinate with patient accounting, physician billing, admissions, and clinical teams to support financial clearance efforts.
  • Maintain accurate documentation and records related to authorizations and insurance verification.
  • Monitor work queues, reports, and system activity to help ensure timely processing and high-quality outcomes.
  • At the Representative II level, manage more complex authorization and insurance-related issues.
  • At the Representative II level, prepare clinical documentation and letters of medical necessity.
  • At the Representative II level, coordinate peer-to-peer reviews between providers and insurance representatives.
  • At the Representative II level, support denial prevention and resolution efforts.
  • At the Representative II level, train and mentor team members.
  • At the Representative II level, review reports to identify opportunities for process improvement and efficiency.
  • At the Representative II level, assist with special projects, system maintenance, and operational initiatives.

Desired Qualifications

  • Previous experience obtaining authorizations or pre-certifications.
  • Experience working with insurance denials, appeals, or payer communications.
  • Knowledge of hospital, physician billing, or oncology-related workflows.
  • Experience preparing clinical documentation to support authorization requests.
  • Experience training, mentoring, or supporting other team members.
  • Strong understanding of healthcare reimbursement processes and regulatory requirements.

About the Company

Roswell Park Comprehensive Cancer Center

Comprehensive cancer research and treatment center

Roswell Park Comprehensive Cancer Center conducts cancer research and patient treatment in a multidisciplinary setting that combines laboratory science, clinical care, and education. Its therapies come from translating laboratory discoveries into patient treatments, including approaches like chemotherapy, photodynamic therapy, and PSA testing. It differentiates itself as the world’s first cancer-focused laboratory, a publicly owned benefit corporation, and the only National Cancer Institute-designated comprehensive cancer center in Upstate New York, funded by grants, donations, and affiliated nonprofits. Its goal is to conquer cancer by coordinating research, clinical care, and education to improve patient outcomes and advance the field.

Company size
1,001-5,000
Company stage
Grant
Total funding
$71.1M
Headquarters
Buffalo, NY
Founded
1898

Recently Posted Jobs

Explore more opportunities at Roswell Park Comprehensive Cancer Center

See more jobs