[Hiring] Financial Clearance Specialist II @UTHealth (University of Texas Health Science Center at Houston)

Role Description

Join UTHealth Houston's Revenue Cycle team as an RCM Financial Clearance Specialist II. In this role, you will be responsible for:

• Verifying insurance benefits and obtaining required authorizations and referrals to ensure financial clearance before patient services.
• Supporting new and established patients by ensuring accurate registration, eligibility, and authorization of services through effective communication with payers, providers, and patients.
• Creating cost estimates and educating patients on financial responsibilities while maintaining compliance with internal policies and external regulations.

The ideal candidate will have:

• Insurance verification experience.
• Knowledge of front-end registration processes.
• The ability to work in a fast-paced environment.

Qualifications

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

Requirements

• Location: Remote within Texas.
• Training: 2-4 weeks onsite at 1851 Crosspoint Ave., Houston, TX 77054.
• Note: Occasional onsite meetings/training may be required. Lodging and mileage reimbursement are not provided.

Benefits

• 100% paid medical premiums for our full-time employees.
• Generous time off (holidays, preventative leave day, both vacation and sick time – all of which equates to around 37-38 days per year).
• The longer you stay, the more vacation you’ll accrue!
• Longevity Pay (Monthly payments after two years of service).
• Build your future with our awesome retirement/pension plan!
• Free financial and legal counseling.
• Free mental health counseling services.
• Gym membership discounts and access to wellness programs.
• Other employee discounts including entertainment, car rentals, cell phones, etc.
• Resources for child and elder care.
• Plus many more!

Position Key Accountabilities

• Analyze benefit information and clinical documentation to ensure appropriate coverage and medical necessity per payer guidelines.
• Perform all registration components from charge review to ensure accurate patient registration and compliance with payer requirements before claim submission.
• 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.
• Identify and update referral authorization numbers when applicable.
• Accurately input and maintain insurance data in Epic based on real-time eligibility response or payor portals.
• Ensure insurance plan selection aligns with the UT Managed Care Payer Plan Tool.
• Identify and report trends in denials, payer issues, or workflow inefficiencies to support continuous improvement and leadership decision-making.
• Maintain compliance with HOOP policies, HIPAA, and payer guidelines.
• Perform other duties as assigned.

Minimum Education

• High School Diploma or equivalent required.
• Associate's Degree in healthcare or business-related field preferred.

Minimum Experience

• 3 years experience in healthcare financial clearance, insurance verification, or a related revenue cycle role required.

Physical Requirements

• Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.

Security Sensitive

• This position is a security-sensitive position pursuant to Texas Education Code §51.215 and Texas Government Code §411.094.
• Personnel in such positions will be routinely reviewed to determine security or integrity qualifications.

Residency Requirement

• Employees must permanently reside and work in the State of Texas.