Financial Clearance Specialist Lead

GENERAL SUMMARY 

The Financial Clearance Specialist Lead plays a critical role in supporting day-to-day financial clearance operations while maintaining a partial frontline workload (30–50%) to remain grounded in the core responsibilities of the team. This role bridges leadership and execution by providing subject matter expertise, coaching, and operational support. The Lead assists the Manager/Supervisor in delegation, process improvements, reporting, and maintaining team efficiency, while also serving as a resource for escalated issues and questions from peers. 

ESSENTIAL JOB FUNCTION/COMPETENCIES 

The responsibilities and duties described in this job description are intended to provide a general overview of the position. Duties may vary depending on the specific needs of the affiliate or location you are working at and/or state requirements. Responsibilities include but are not limited to:

• Performs frontline responsibilities including prior authorizations and patient estimations.
• Maintains current knowledge of workflows, payer requirements, and tools used by the team.
• Stays engaged in the hands-on work to ensure relevance and empathy in leadership decisions.
• Responds to frontline questions regarding tactics, workflows, and payer nuances.
• Acts as a go-to resource for troubleshooting complex issues and internal system challenges.
• Coaches peers through difficult cases or unusual scenarios to ensure consistency and accuracy
• Assists the Manager/Supervisor in delegating workload across the team.
• Provides coaching to promote equitable task distribution and appropriate prioritization.
• Monitors progress and rebalances tasks to optimize throughout and reduce bottlenecks.
• Mentors team members on technical and professional development.
• Supports onboarding and ongoing education through one-on-one coaching and informal check-ins.
• Encourages skill growth and fosters a collaborative learning environment.
• Assists in developing and interpreting production and quality data.
• Shares actionable insights with the team to promote accountability and transparency.
• Compiles quality sample reviews and supports the creation of monthly performance dashboards.
• Collaborates with the Manager to help define team and individual goals.
• Identifies workflow gaps, communication barriers, and technology limitations.
• Proposes and supports implementation of solutions to improve efficiency and outcomes.
• Helps coordinate schedule coverage and workload balancing across shifts.
• Serves as an escalation point for advanced technical issues and payer-related complexities.
• Provides high-level support for internal systems navigation and issue resolution.
• Assists in compiling and delivering reporting for leadership review.
• Participates in meetings and huddles, sharing team insights and opportunities for improvement.
• Keeps communication clear between staff and management to ensure alignment.
• Performs other position related duties as assigned.
• Employees shall adhere to high standards of ethical conduct and will comply with and assist in complying with all applicable laws and regulations. This will include and not be limited to following the Solaris Health Code of Conduct and all Solaris Health and Affiliated Practice policies and procedures; maintaining the confidentiality of patients' protected health information in compliance with the Health Insurance Portability and Accountability Act (HIPAA); immediately reporting any suspected concerns and/or violations to a supervisor and/or the Compliance Department; and the timely completion the Annual Compliance Training.

CERTIFICATIONS, LICENSURES OR REGISTRY REQUIREMENTS

• N/A

KNOWLEDGE | SKILLS | ABILITIES

• Strong interpersonal and coaching skills.
• Proficiency in EHRs, payer portals, and Microsoft Office.
• Excellent organizational and problem-solving abilities.
• Comfortable analyzing data and discussing performance metrics.
• Adaptability and a proactive, collaborative mindset.
• Excellent verbal and written communication skills.
• Well organized with the ability to maintain accuracy and confidentiality.

EDUCATION REQUIREMENTS

• Associate’s degree in healthcare, business, or related field required. Bachelor’s degree preferred.

EXPERIENCE REQUIREMENTS

• 2+ years of experience in healthcare financial clearance, revenue cycle, or prior authorizations.
• Previous experience in a mentoring or team leadership role strongly preferred.

REQUIRED TRAVEL

• N/A

PHYSICAL DEMANDS

Carrying Weight Frequency

1-25 lbs. Frequent from 34% to 66%

26-50 lbs. Occasionally from 2% to 33%

Pushing/Pulling Frequency

1-25 lbs. Seldom, up to 2%

100 + lbs. Seldom, up to 2%

Lifting - Height, Weight Frequency

Floor to Chest, 1 -25 lbs. Occasional: from 2% to 33%

Floor to Chest, 26-50 lbs. Seldom: up to 2%

Floor to Waist, 1-25 lbs. Occasional: from 2% to 33%

Floor to Waist, 26-50 lbs. Seldom: up to 2%