[Hiring] Financial Clearance Specialist II @UTHealth Houston

Role Description

The RCM Financial Clearance Specialist II is responsible for verifying insurance benefits and obtaining required authorizations and referrals to ensure financial clearance before patient services. This position supports new and established patients by ensuring accurate registration, eligibility, and authorization of services through effective communication with payers, providers, and patients. The Specialist also creates cost estimates and educates patients on financial responsibilities while maintaining compliance with internal policies and external regulations.

In this senior-level role, you will:

• Lead complex insurance verification and authorization activities.
• Ensure accurate financial clearance and resolve payer issues.
• Support patients through the healthcare journey.
• Serve as a mentor to team members.
• Maintain excellence in Epic documentation, compliance, and customer service.

Qualifications

• 3+ years of insurance authorization, verification, or healthcare financial clearance experience.
• Experience resolving complex insurance cases.
• Epic experience preferred.
• Associate degree preferred.

Requirements

• Analyze benefit information and clinical documentation to ensure appropriate coverage and medical necessity per payer guidelines.
• Obtain prior authorizations for services per insurance policies and initiate Peer-to-Peer (P2P) reviews as needed.
• Collaborate with clinical, scheduling, and financial teams for financial clearance.
• Communicate benefits and cost estimates with patients.
• Accurately input and maintain insurance data in Epic based on real-time eligibility response or payor portals.
• Identify and report trends in denials, payer issues, or workflow inefficiencies.
• Maintain compliance with HOOP policies, HIPAA, and payer guidelines.
• Perform other duties as assigned.

Benefits

• Remote work within Texas.
• 2-4 weeks onsite training beginning November 3, 2026, at 1851 Crosspoint Ave., Houston, TX 77054.
• Occasional onsite meetings/training may be required.
• Lodging and mileage reimbursement are not provided.

Company Description

Join UTHealth Houston's Revenue Cycle team as an RCM Financial Clearance Specialist II.