Financial Clearance Manager

Aces•San Diego, CA

11h

About The Position

ACES is driven to elevate the standards in the treatment of autism. Our team of Applied Behavior Analysis (ABA) clinicians is deeply committed to helping children with autism and related disorders reach their fullest potential through home and clinic-based services. ACES is the only autism provider who is nationally recognized for quality care as part of Aetna/CVS’s Institute of Quality . We are also an award-winning workplace where you can grow your career, collaborate with a supportive team, and make a lasting impact on the lives of people in your community. Position Summary: The Financial Clearance Manager is responsible for overseeing all front-end revenue cycle functions related to patient financial clearance, including verification of benefits (VOB), eligibility, prior authorizations, reauthorizations, and payor-to-payor transitions. This role manages and develops a high-performing team, ensuring that all processes support timely and accurate service delivery, reduce denials, and promote an optimal patient and client experience.

Requirements

Bachelor’s degree in Healthcare Administration, Business, or related field required (or equivalent experience).
Minimum of 3–5 years of experience in healthcare revenue cycle operations, with at least 2 years in a supervisory or management role.
Deep knowledge of VOB, eligibility, authorizations, reauthorizations, and insurance transitions across commercial, government, and specialty payors.
Familiarity with ABA, behavioral health, or outpatient care settings preferred.
Strong leadership, interpersonal, and communication skills.
Proficient with EMR/EHR systems and revenue cycle technology tools.
Highly organized with attention to detail and a problem-solving mindset.

Nice To Haves

Experience in a multi-state, multi-payor healthcare organization.
Knowledge of Medicaid, TRICARE, Regional Centers, and school district funding sources.
Bilingual capabilities a plus.

Responsibilities

Team Leadership & Oversight: Lead, coach, and mentor a team of specialists responsible for VOB, eligibility checks, authorization/reauthorization management, and payor transitions.
Set performance goals, conduct regular check-ins and reviews, and provide training to ensure accuracy, efficiency, and compliance.
Foster a culture of accountability, customer service, and operational excellence.
Process Management & Optimization: Develop and refine workflows and SOPs to support timely insurance verification and authorization processing.
Identify and implement process improvements that reduce errors, improve turnaround times, and enhance payer compliance.
Monitor daily volumes, queues, and productivity metrics to ensure timely completion of all tasks.
Cross-Departmental Collaboration: Partner with scheduling, intake, clinical operations, and billing teams to ensure seamless handoffs and support continuity of care.
Collaborate with payor relations and credentialing teams to stay ahead of policy changes and network updates that affect authorization workflows.
Compliance & Documentation: Ensure compliance with HIPAA, payer-specific guidelines, and internal policies.
Maintain accurate and complete documentation in systems of record to support downstream billing and appeals.
Payor Transitions: Oversee processes for managing changes in patient insurance, including transitions between commercial, Medicaid, regional centers, and other payer types.
Ensure seamless coverage transitions to avoid lapses in care or reimbursement delays.