Financial Clearance & Insurance Authorization Lead - 141750

University of California San Diego; San Diego (CA); On-site; USD 67,000 - 88,000; Full time

Job summary

UC San Diego Health's Revenue Cycle department seeks a Financial Clearance & Insurance Authorization Lead to verify insurance eligibility, obtain pre-certifications, and communicate coverage status with patients and providers. The Lead mentors others and may participate in Epic-related testing and training.

The role requires hospital or professional services pre-access or billing experience, strong customer service, and ability to resolve denials.

Qualifications

• Minimum of four (4) years of hospital and/or professional services pre-access or billing experience.
• Experience with insurance eligibility and benefits verification and obtaining pre-certification/authorization.
• Successful completion of training on Epic patient registration and scheduling applications.
• Demonstrated understanding of excellent customer service, communications, and problem resolution in healthcare.
• College degree may compensate for fewer years of experience.

Responsibilities

• Verify insurance eligibility and benefits coverage and obtain pre-certification/authorization for medical services.
• Communicate coverage status directly with patients and providers and estimate patient financial responsibility.
• Serve as Epic application super-user and assist with training and testing during changes.

Skills

Customer service

Communication skills

Problem solving

Education

College degree

Tools

Epic

Job description

Payroll Title: PAT BILLER 4

Department: ADMISSIONS

Hiring Pay Scale: $31.87 - $42.05 / Hour

Worksite: Greenwich Drive

Appointment Type: Career

Appointment Percent: 100%

Union: EX Contract

Total Openings: 2

Work Schedule: Days, 8 hrs/day, Monday-Friday

#141750 Financial Clearance & Insurance Authorization Lead

UC San Diego values and welcomes people from all backgrounds. If you are interested in being part of our team, possess the needed licensure and certifications, and feel that you have most of the qualifications and/or transferable skills for a job opening, we strongly encourage you to apply.

UCSD Layoff from Career Appointment: Apply by 10/19/26 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.

Reassignment Applicants: Eligible Reassignment clients should contact their Disability Counselor for assistance.

This is an internal posting open only to employees within the UC San Diego Health – Admissions department

DESCRIPTION

UC San Diego Health's Revenue Cycle department supports the organization's mission to deliver outstanding patient care and to create a healthier world — one life at a time. We are a diverse, patient-focused, high-performing team with a commitment to quality, collaboration, and continuous improvement that enables us to deliver the maximum standard of care to our patients. We offer challenging career opportunities in a fast-paced and innovative environment and we embrace individuals who demonstrate a deep passion for problem-solving and customer service.

The Financial Clearance and Insurance Authorization Lead is a seasoned professional responsible for financially securing scheduled and unscheduled hospital and professional services by verifying insurance eligibility and benefits coverage, and by securing insurance pre-certification and/or authorization for inpatient and/or outpatient services. The Lead communicates the status of coverage/benefits verification and authorization directly with patients and providers, and facilities rescheduling of services as appropriate. The Lead estimates and collects patient liability amounts. The Lead serves as an Epic application super-user, participates in Epic change/upgrade end-user testing and training, researches and resolves authorization denials, and assists with root cause analysis and resolution of work flow issues. Position is at an expert level and serves as a mentor to other Specialists. Hospital and/or professional services pre-access or billing experience.

MINIMUM QUALIFICATIONS

• Minimum of four (4) years of hospital and/or professional services pre-access or billing experience in an academic or other complex, multispecialty setting. Will consider less than three (3) years of experience for candidates with a college degree.
• Experience must include insurance eligibility and benefits coverage verification, obtaining pre-certification and/or authorization for medical services, and providing explanations and/or estimates of patient financial responsibility.
• Must have experience with insurance/benefits verification portals or other applications, and successful completion of training on Epic patient registration and scheduling applications.
• Hospital and/or professional services pre-access or billing experience
• Demonstrated understanding of principles of excellent customer service, customer communications, and/or problem resolution relevant to healthcare settings.

PREFERRED QUALIFICATIONS

• Five (5+) or more years of relevant experience preferred.
• Experience with both hospital and professional services pre-certification and authorization experience preferred. Prefer experience with benefits verification and authorization initial and additional inpatient hospital days, inpatient and outpatient procedures, outpatient diagnostic services, provider consultations and other visits, prescription drugs, SNF, rehabilitation services, durable medical equipment, and home health.
• Community college or university courses in medical terminology, medical coding, finance or other relevant subject matter.

SPECIAL CONDITIONS

• Must be able to work various hours and locations based on business needs.
• Employment is subject to a criminal background check and pre-employment physical.

Pay Transparency Act

Annual Full Pay Range: $66,545 - $87,800 (will be prorated if the appointment percentage is less than 100%)

Hourly Equivalent: $31.87 - $42.05

Factors in determining the appropriate compensation for a role include experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. The Hiring Pay Scale referenced in the job posting is the budgeted salary or hourly range that the University reasonably expects to pay for this position. The Annual Full Pay Range may be broader than what the University anticipates to pay for this position, based on internal equity, budget, and collective bargaining agreements (when applicable).

If employed by the University of California, you will be required to comply with our Policy on Vaccination Programs, which may be amended or revised from time to time. Federal, state, or local public health directives may impose additional requirements. If applicable, life-support certifications (BLS, NRP, ACLS, etc.) must include hands‑on practice and in‑person skills assessment; online‑only certification is not acceptable.

UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, the only Burn Center in the county, and dozens of outpatient clinics. We invite you to join our team!

Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.

To foster the best possible working and learning environment, UC San Diego strives to cultivate a rich and diverse environment, inclusive and supportive of all students, faculty, staff and visitors. For more information, please visit UC San Diego Principles of Community.

The University of California 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, disability, age, protected veteran status, or other protected status under state or federal law.

For the University of California’s Anti-Discrimination Policy, please visit https://policy.ucop.edu/doc/1001004/Anti-Discrimination

UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.

UC San Diego Health maintains a marijuana and drug free environment. Employees may be subject to drug screening.

Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.

a. "Misconduct" means any violation of the policies governing employee conduct at the applicant’s previous place of employment, including, but not limited to, violations of policies prohibiting sexual harassment, sexual assault, or other forms of harassment, or discrimination, as defined by the employer. For reference, below are UC’s policies addressing some forms of misconduct:

• UC Sexual Violence and Sexual Harassment Policy
• UC Anti-Discrimination Policy
• Abusive Conduct in the Workplace