Financial Clearance Specialist III - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
$52,000–$82,555 year
On-site · Los Angeles, California, United States
Job Summary
Financial Clearance Specialist III located in Los Angeles, CA for Keck Medicine of USC. Responsible for insurance eligibility, benefit verification, and authorizations to prevent denials and optimize reimbursement. Duties include verifying demographic information, determining pre-certification/authorization requirements, communicating with providers about out-of-network issues, calculating patient liability, submitting authorizations via Valor software, maintaining registration data, and ensuring accurate CPT/ICD coding. Requires HIPAA compliance, medical terminology knowledge, and strong communication and problem-solving skills. Benefits information and equal opportunity employment statements are provided in the posting.
Required Qualifications
- Req High school or equivalent Or GED required
- Req 2 years Admitting/ insurance verification experience in a hospital, health plan or Physician office environment
- Req Broad experience in financial counseling and co-pay collections
- Req Ability to submit authorization and articulate full insurance benefits for Surgery, GI, Imaging, Chemo Therapy, Infusions, and invasive and non- invasive procedures is highly desirable
- Req The extended ability to perform mathematical calculations, extensive experience in hospital and medical business office setting
- Req Ability to interrupt patient’s insurance coverage, identify services that are not covered benefit and provide clear explanation to patients and providers
- Req Strong problem solving customer skills
- Req Knowledge of business office procedures
- Req Knowledge of medical terminology and coding
- Req Knowledge of grammar, spelling, and punctuation to type patient information
- Req Must be able to verify insurance and advanced knowledge of both CPT codes and medical terminology
- Req Must also be able to understand and interpret patient liability and benefits for HMOs and all payer types
- Req Ability to read, understand, and follow oral, and written instructions and establish and maintain effective working relationships with patients, employees, and the public
- Req Excellent time management, organizational skills, research/analytical skills, negotiation, communication (written and verbal), and interpersonal skills
- Req Capable of reading the policy and procedure manual and understanding information pertaining to specific job duties and the general information for all hospital employees
This role has closed. Sorce can match you with similar open roles and apply on your behalf.
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.