Financial Clearance & Insurance Authorization Sp I - 141751

University of California San Diego; San Diego (CA); Presencial; USD 65 000 - 86 000; Tempo integral

Resumo da oferta

UC San Diego Health's Revenue Cycle team seeks a Financial Clearance & Insurance Authorization Specialist I to verify insurance eligibility, obtain pre-certification, and communicate coverage to patients and providers. The role involves providing estimated patient liability and coordinating service scheduling within a complex academic health system.

Ideal candidates have hospital/pre-access experience, strong customer service skills, and proficiency with Epic and MS Office.

Qualificações

• Hospital and/or professional services pre-access or billing experience.
• Three years of hospital and/or professional services pre-access or billing experience in a multispecialty setting.
• Experience with insurance eligibility and benefits coverage verification, pre-certification and/or authorization, and patient financial responsibility explanations.

Responsabilidades

• Verify insurance eligibility and benefits coverage; obtain pre-certification/authorization.
• Communicate coverage status with patients and providers and reschedule services as needed.
• Provide and collect estimated patient liability amounts and explanations of benefits.

Conhecimentos

Customer service

Insurance verification

Communication

Attention to detail

Problem solving

Formação académica

College degree

Ferramentas

Epic

MS Office

Descrição da oferta de emprego

Payroll Title: PAT BILLER 3

Department: ADMISSIONS

Hiring Pay Scale: $31.04 - $40.95 / Hour

Worksite: Greenwich Drive

Appointment Type: Career

Appointment Percent: 100%

Union: EX Contract

Total Openings: 9

Work Schedule: Days, 8 hour shifts, Monday-Friday

#141751 Financial Clearance & Insurance Authorization Sp I

Filing Deadline: Thu 10/15/2026 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.

UCSD Layoff from Career Appointment: Apply by 10/12/26 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 Specialist I is an experienced revenue cycle 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 Specialist communicates the status of coverage/benefits verification and authorization directly with patients and providers, and facilities rescheduling of services as appropriate. The Specialist provides and collects estimated patient liability amounts.

MINIMUM QUALIFICATIONS

• Hospital and/or professional services pre-access or billing experience.

• Minimum of three (3) years of hospital and/or professional services pre-access or billing experience in an academic or other complex, multispecialty setting. Including 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.

• Will consider less than 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 experience with Epic or other similar patient registration, scheduling and/or billing information systems.

• Demonstrated understanding of principles of excellent customer service, customer communications, and/or problem resolution relevant to healthcare settings.

• Demonstrated knowledge eligibility, covered benefits, medical necessity and pre-authorization rules for federal, state, and commercial third-party payers.

• Demonstrated knowledge of medical terminology, CPT, ICD-10, HCPCS, NDC, and modifier codes, including impact on benefits eligibility, authorization, and reimbursements for medical services.

• Demonstrated ability to understand and interpret payer contract terms and insurance verification/benefits eligibility responses.

• Demonstrated understanding of deductibles, coinsurance and non-covered benefits, and ability to derive accurate estimate of patient responsibility.

• Demonstrated ability to communicate effectively, verbally and in writing.

• Demonstrated ability to pay attention to details and follow through independently, analyze and resolve problems effectively, and communicate professionally and effectively with coworkers, UCSD clinical departments and providers, third-party payers, UCSD revenue cycle departments, and patients to meet financial, clinical care and customer service goals of the organization.

• Demonstrated proficiency in use of Microsoft Office applications (including Outlook, Skype/Lync, Excel and Word).

PREFERRED QUALIFICATIONS

• Prior authorization experience highly preferred.

• Community college or university courses in medical terminology, medical coding, finance or other relevant subject matter.

• NAHAM Certified Healthcare Access Manager, HFMA Certified Revenue Cycle Representative, and/or Certified Procedural Coder (CPC or CPC-H) certifications.

• A minimum of four (4+) or more years of relevant experience.

• Experience with both hospital and professional services pre-certification and authorization experience.

• 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.

• Experience working with Epic registration, scheduling and referral applications.

• Completion of organization-sponsored or professional organization training in principles of customer service, customer communications and/or problem resolution relevant to healthcare settings.

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: $64,812 - $85,504 (will be prorated if the appointment percentage is less than 100%)

Hourly Equivalent: $31.04 - $40.95

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