Financial Clearance Specialist III - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

Job ID: REQ20175593 | Posted: 05/21/2026

About the Role

The Financial Clearance Specialist III ensures insurance eligibility, benefit verification, and authorization processes are completed within insurance company timelines to prevent denials or penalties. This role involves documenting accurate insurance and authorization details to optimize reimbursement from payers and patients, maintaining a strong working knowledge of insurance plans, contract requirements, and resources to facilitate appropriate verification and authorization.

Responsibilities

• Run eligibility and secure full benefit coverage information (including COBRA when applicable) with insurance companies and employers, confirm demographic accuracy, and ensure coordination of benefit (COB) and insurance plan codes are correct.
• Verify insurance coverage immediately for inpatient and outpatient accounts that are same-day and next-day add-ons.
• Determine if pre-certification, pre-authorization, or a referral is required and obtain it if applicable.
• Communicate with providers and team regarding out-of-network issues, assess contracted and non-contracted payer issues, and document outcomes and next steps.
• Determine, communicate, and collect patient liability prior to service, including prior balances.
• Conduct all transactions appropriately and consistently, and complete the Medicare Secondary Questionnaire accurately with the patient or their representative.
• Maintain compliance with HIPAA regulations as they pertain to insurance processes.
• Submit authorizations for surgery, GI, imaging, chemotherapy, infusions, invasive and non-invasive procedures, transplants, and other required services.
• Update professional and/or hospital registration systems and ensure all insurance plans are properly selected in registration and scheduling systems.
• Contact insurance companies or use internet portals to obtain and document:
  • Insurance eligibility and benefits
  • Financial responsibility
  • Authorization and/or pre-certification as required
• Understand and articulate patient liability by performing calculations for out-of-pocket costs, co-insurance, and deductibles, including full calculations for surgery, GI, chemo/infusions, and imaging procedures.
• Contact physician offices when services are denied, redirected, or when a peer-to-peer review is required. Communicate regarding proposed admissions, special procedures, outpatient referrals, and same-day surgeries.
• Submit authorizations via Valor software or websites, following appropriate protocols.
• Clear assigned worklists in information systems.
• Document all authorization information in registration fields following approved guidelines. Submit pre-certification documentation to third-party payers with correct CPT and ICD coding.
• Research payer medical policy requirements for treatment authorizations and understand the process for submitting pre-certification requests.
• Follow up on routine requests from the message center within 3-5 business days.
• Scan all authorizations into the appropriate system under respective patient accounts and document authorization outcomes in the registration system.
• Maintain professional development by attending workshops, in-services, and webinars to stay current on insurance rules, regulations, and industry changes.
• Perform all other duties as assigned.

Requirements

• High school diploma or equivalent (GED).
• Minimum of 2 years of 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 authorizations and articulate full insurance benefits for surgery, GI, imaging, chemotherapy, infusions, and invasive/non-invasive procedures.
• Strong mathematical skills and extensive experience in a hospital or medical business office setting.
• Ability to interpret patient insurance coverage, identify non-covered services, and provide clear explanations to patients and providers.
• Strong problem-solving and customer service skills.
• Knowledge of business office procedures, medical terminology, and coding.
• Proficiency in grammar, spelling, and punctuation for typing patient information.
• Advanced knowledge of CPT codes, medical terminology, and the ability 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 effective working relationships with patients, employees, and the public.
• Excellent time management, organizational, research/analytical, negotiation, communication (written and verbal), and interpersonal skills.
• Capable of reading policy and procedure manuals and understanding information specific to job duties and general hospital employee guidelines.

Preferred Qualifications

• Fire Life Safety Training (LA City) certification. If not held upon hire, must be obtained within 30 days and maintained by renewal before expiration (required within LA City only).

Pay

The hourly rate range for this position is $25.00 - $39.69. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.