Financial Clearance Specialist IV - Admitting - Full Time 8 Hour Variable Shift (Non Union)

The Financial Clearance Specialist IV is responsible for ensuring insurance eligibility, benefit verification, and the authorization processes are complete. Documentation of accurate insurance information, knowledge of insurance plans and authorization details to optimize reimbursement from the payer are required. The Specialist IV must maintain strong working knowledge of insurance plans, contract requirements, and resources. Responsibilities Ensure insurance eligibility, benefit verification, and authorization processes are complete. Document accurate insurance information and optimize reimbursement from the payer. Adjudicate Letters of Agreement to streamline the claim management process. Secure mutually signed Letters of Agreement to outline intent and support appeals for non‑contracted payers. Maintain a strong working knowledge of insurance plans, contract requirements, and resources. Determine, communicate, and collect patient liability prior to service and attempt to collect prior balances. Conduct all transactions appropriately and consistently, and complete Medicare Secondary Questionnaire accurately with the patient or representative. Maintain compliance with HIPAA regulations as it pertains to the insurance processes. Attend workshops, in‑services, and webinars to remain up‑to‑date on insurance rules, regulations, and industry changes. Interpret language specific to covered services and be proficient in hospital and professional contracted versus non‑contract payers. Understand and submit payer DOFR and authorization for all service scopes in both hospital and professional settings. Qualifications Minimum Education: HS Diploma or GED required. Minimum Experience: At least 3 years in a hospital, health plan, or physician office environment with extensive knowledge of contracted and non‑contract payers, and division of financial responsibility. Ability to articulate benefit negotiations when adjudicating a letter of agreement with a non‑contracted payer. Proficient in submission of authorization for all service types rendered within a hospital and/or professional setting. Knowledge of business office procedures, medical terminology, and coding. Excellent grammar, spelling, and punctuation for typing patient information. Extended understanding of payer DOFR and authorization submission for all service scopes performed in both a hospital and professional setting. Ability to read, understand, and follow oral and written instructions and establish effective working relationships with patients, employees, and the public. Excellent time management, organizational, research/analytical, negotiation, and communication (written and verbal) skills. Capable of working assigned shifts and overtime when approved. Capable of reading the policy and procedure manual and understanding general information for all hospital employees. Advanced knowledge of CPT codes, medical terminology, and patient liability for HMOs and all payer types. Proficient in interpreting and completing insurance verification for all types of payers including HMO, Commercial, Medi-Cal and Senior Plans, Medicare, PPO, POS, EPO, Capitation, Military, Workman's Compensation. Compensation The hourly rate range for this position is $26.00 - $34.00. EEO and Accommodation USC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other characteristic protected by law or USC policy. USC observes affirmative action obligations consistent with state and federal law. USC will consider for employment all qualified applicants with criminal records in a manner consistent with applicable laws and regulations, including the Los Angeles County Fair Chance Ordinance for employers and the Fair Chance Initiative for Hiring Ordinance, and with due consideration for patient and student safety. We provide reasonable accommodations to applicants and employees with disabilities. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact USC Human Resources by phone at View phone number on click.appcast.io, or by email at View email address on click.appcast.io. #J-18808-Ljbffr University of Southern California