Financial Clearance Coordinator

UT MD Anderson Cancer Center • Houston, TX

9h • Remote

About The Position

The Financial Clearance Coordinator supports patient access to care by coordinating clinical and financial clearance activities, including insurance verification, authorization management, medical necessity review, financial counseling, and clinical documentation review. The role applies nursing expertise and professional judgment to address authorization and utilization-review needs, supports peer-to-peer engagement, and works with patients, payors, third-party vendors, Patient Access teams, and clinical staff to resolve barriers to care. It also reviews clinical-trial coverage responsibilities and helps patients understand expected costs and financial obligations. The position is remote, with the ability to come onsite as needed, and is scheduled Monday through Friday, 8 a.m. to 5 p.m.

Requirements

• Graduation from an accredited school of nursing.
• Two years of nursing experience, or one year of related nursing experience in utilization review, insurance, case management, or medical clearance.
• Texas State Professional Nursing license (RN), required upon hire.
• Basic Life Support (BLS), required upon hire, or Cardiac Pulmonary Resuscitation (CPR), required upon hire.

Nice To Haves

• Two years of oncology nursing experience.
• Two years of utilization review experience with external payors in a hospital or insurance setting.
• Research, clinical-trial knowledge, and authorization experience.
• Certified Case Manager (CCM) certification.
• Certified Healthcare Access Manager (CHAM) certification.
• Advanced Cardiac Life Support (ACLS) certification, as required by the patient-care area.
• Pediatric Advanced Life Support (PALS) certification, as required by the patient-care area.

Responsibilities

• Verify and document patient eligibility, effective dates, and benefits using institutional systems, payor systems, web portals, and other available tools within departmental timeframes.
• Notify Patient Access and patients when eligibility information is invalid or cannot be verified.
• Enter accurate eligibility and benefits information into the electronic health record in a timely manner.
• Manage cases requiring pre-authorization and coordinate with payors or assigned third-party vendors.
• Obtain pre-authorizations through online portals and available authorization tools when possible.
• Document authorization and reference numbers, payor contacts, outcomes, and communications in the electronic health record.
• Apply clinical knowledge and judgment to support pre-authorization activities and assist associates with clinical interpretation, medical necessity justification, and clinical review.
• Support peer-to-peer engagement related to authorization and utilization review.
• Assess and interpret patients' clinical conditions to help resolve financial clearance issues, and stay current with relevant documentation requirements and professional publications.
• Review clinical-trial participation and identify services covered by sponsors versus patient insurance.
• Communicate clinical-trial coverage responsibilities to patients and payors and document related clearance activities.
• Provide financial counseling about estimated costs and expected patient responsibility, including co-payments, deductibles, and co-insurance.
• Discuss payment requirements, payment plan options, and financial assistance opportunities when applicable.
• Review Advance Beneficiary Notices, Medicare Secondary Payer Questionnaires, account status, and financial clearance barriers with patients.
• Collaborate with Patient Access to document updated or corrected insurance information according to departmental policies and procedures.
• Respond promptly to emails and phone calls and address voicemails and in-basket messages within one business day.
• Maintain professional and courteous relationships with patients, physicians, payors, vendors, and business partners.
• Escalate financial clearance or counseling issues to the Financial Clearance Supervisor when appropriate and seek support from other Financial Clearance Coordinators when needed.
• Complete and submit required documents, including PFA and COBRA-related documentation requiring supervisor approval.
• Participate in educational, training, and mentoring opportunities, and perform other duties as assigned.

Benefits

• Employer-paid medical coverage starting day one for employees working 30 or more hours per week.
• Optional group dental, vision, life, accidental death and dismemberment, and disability insurance.
• Accruals for paid time off and an Extended Illness Bank.
• Paid holidays and wellness, childcare, and other leave options.
• Tuition Assistance Program after six months of service.
• Wellness, fitness, and employee resource groups.
• Defined-benefit pension through the Teachers Retirement System and voluntary retirement plans.
• Employer-paid life and reduced salary protection programs.
• Educational opportunities and individual and team recognition.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed