University of Southern California · 11 hours ago
Financial Clearance Specialist III - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
Alhambra, CA
Full-time
Onsite
Entry, Mid Level
$22/hr - $34.18/hr
2+ years expThe University of Southern California is seeking a Financial Clearance Specialist III responsible for ensuring insurance eligibility, benefit verification, and authorization processes. The role involves documenting accurate insurance information and maintaining compliance with regulations to optimize reimbursement from payers and patients.
EducationHigher EducationUniversities
Responsibilities
Responsible for obtaining insurance information/verification/authorization to ensure financial clearance of patient accounts. Updates both professional and / or hospital registration systems. Ensure all insurance plans are properly selected in all registration and scheduling information systems. Responsible for calling insurance or use Internet portals to obtain and document: a) Insurance eligibility and benefits, b) Financial responsibility, c) Authorization and / or Pre-Certification as required. (20%)
Responsible for understanding and articulating patient’s liability by performing mathematical calculations in understanding out of pocket, co-insurance and deductible calculations. Responsible for full calculations on all Surgery, GI, Chemo/Infusions, Imaging on non and invasive procedures by following the appropriate documentation standard guidelines. (20%)
Responsible for contacting Physician office when a patient’s services are denied, re-directed and or when a Peer to Peer is required. Communicate with physician offices regarding proposed admissions, special procedures, outpatient referrals and same day surgeries. (20%)
Responsible for submitting authorizations for Surgery, GI, Chemo/Infusions, Imaging on non and invasive procedures. Submits authorizations via the Valor software tool and or websites and follows the appropriate protocol when submitting authorizations. Responsible for clearing assigned worklists in any of the information systems (15%)
Responsible for completing Documentation of all authorization information is entered in all appropriate registration fields and follows the approved documentation standard guidelines. Submit pre-certification documentation to third party payers for authorization with correct CPT and ICD coding. Research payer medical policy requirements for treatment authorizations and understand process for submitting pre-certification requests. Follow up for routine requests from the message center are followed up on 3-5 business days consistently. Scan all authorizations into appropriate system under the respective patient accounts and document authorization outcomes in the registration system. (15%)
Perform all other duties as assigned. (10%)
Qualification
Required
High school or equivalent
Be able to relate to supervising therapist any problems with patients, department operations or problems from other areas
Capable of reading the policy and procedure manual and understanding the information that relates to listed job duties as well as general information available for all employees of the hospital
Capable of demonstrating compliance with safety, hazardous waste and infection control procedures
Utilizes proper body mechanics with patients in order to prevent injury to the patient or to self
Capable of working assigned shifts, overtime when approved and weekends if requested
Adheres to all hospital and departmental policies and procedures, including annual updates of emergency procedures
Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)
Preferred
High school or equivalent Or GED required
2 years Admitting/ insurance verification experience in a hospital, health plan or Physician office environment
Broad experience in financial counseling and co-pay collections
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
The extended ability to perform mathematical calculations, extensive experience in hospital and medical business office setting
Ability to interrupt patient's insurance coverage, identify services that are not covered benefit and provide clear explanation to patients and providers
Strong problem solving customer skills
Knowledge of business office procedures
Knowledge of medical terminology and coding
Knowledge of grammar, spelling, and punctuation to type patient information
Must be able to verify insurance and advanced knowledge of both CPT codes and medical terminology
Must also be able to understand and interpret patient liability and benefits for HMOs and all payer types
Ability to read, understand, and follow oral, and written instructions and establish and maintain effective working relationships with patients, employees, and the public
Excellent time management, organizational skills, research/analytical skills, negotiation, communication (written and verbal), and interpersonal skills
Capable of reading the policy and procedure manual and understanding information pertaining to specific job duties and the general information for all hospital employees
Company
University of Southern California
University of Southern California is a private research university offering opportunities for interdisciplinary study and collaboration.
10001+ employees
H1B Sponsorship
University of Southern California has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (253)
2024 (239)
2023 (172)
2022 (207)
2021 (182)
2020 (195)
Funding
Current Stage
Late StageTotal Funding
$19.64MKey Investors
Patient-Centered Outcomes Research InstituteCalifornia Institute for Regenerative MedicineCDA Foundation
2025-02-04Grant· $10.8M
2025-01-30Grant· $5.93M
2024-07-30Grant
Leadership Team
David A Barnhart
Director, USC Space Engineering Research Center
H
Hossein Pourmand
Assistant Vice President, Research Initiatives, University Advancement
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