Financial Clearance Specialist I

Financial Clearance Specialist II

Location: Vaccination Status + Booster Status ***** Do not note on Resume**** Assignment Details:

• Campus or Medical Enterprise: Medical Enterprise
• Job Title: Financial Clearance Specialist II
• Number of Needs: 2
• Duration of Assignment: 6 months (possibility to be extended or to go perm)
• Target Start Date: 9/26/2022 OR sooner
• USC Address where work is being performed: 1000 S. Fremont Ave. Unit 16, Bldg A6 Alhambra, Ca 91803
• Will this position be virtual, onsite, or hybrid?: 100 % Onsite
• Department: Pre-Arrival
• Parking / Cost: No parking cost-parking permit will be provided
• Pay: $4/hr (max)
• Bill: $#####/hr (max)
• Mark up: 40%
• Working Days/Hours: 7 am-3:30 pm, 8:00 am-4:30 pm and 8:30 am-5:00 pm
• Dress Code: Business Casual
• Manager Name: Sandra Rivera
• Timecard Approver: Sandra Rivera
• Interview Process: 1 MS Teams interview with HMS

Must Have's This role requires insurance knowledge skill set and Medicare advantage sign-over plans or point of service plans. This role requires knowledge across all health plans and their products 1-2 years of insurance knowledge and benefit verification Strong working knowledge of insurance plans. High Levels of attention to detail High School Diploma

Job Description:

• The Financial Clearance Specialist is responsible for ensuring insurance eligibility, benefit verification and the authorization processes are complete in the time allowed by the insurance companies to prevent denials or penalties.
• Specialists are responsible for documenting accurate insurance information and authorization details to optimize reimbursement from both the payer and patient.
• The Specialist must maintain strong working knowledge of insurance plans, contract requirements, and resources to facilitate appropriate insurance verification and authorization.
• Individuals must be able to run eligibility and secure full benefit coverage information (including COBRA when applicable) with insurance companies and employers, confirm all demographic information is correct, and ensure coordination of benefit (COB) and insurance plan codes are accurate.
• Specialists must verify insurance coverage immediately for inpatient and outpatient accounts that are same-day and next-day add-ons.
• Financial Clearance Specialists must determine if pre-certification, pre-authorization or a referral is required for insurance companies and obtain if applicable.
• Specialists must also determine, communicate, and collect patient liability prior to service and attempt to collect prior balances.
• Representatives are to conduct all transactions appropriately and consistently, and complete Medicare Secondary Questionnaire accurately with the patient or patient representative.
• Medical Enterprise - Non-Clinical Onboarding - Must complete all onboarding requirements prior to the start date, with no exceptions.