Financial Clearance Specialist II - Revenue Cycle

UTHealth Houston•Houston, TX

7d•Remote

About The Position

The RCM Financial Clearance Specialist II verifies insurance benefits and obtains required authorizations and referrals to ensure patients are financially cleared before receiving services. The role supports new and established patients by ensuring accurate registration, eligibility, and authorization through communication with payers, providers, and patients. It also involves preparing cost estimates and explaining patients’ financial responsibilities while following internal policies and external regulations. The Specialist handles daily operations for assigned providers, maintains productivity and UTHealth Houston metrics, and resolves insurance issues while delivering positive patient service. The position is remote, but requires 2–4 weeks onsite for training at 1851 Crosspoint Ave, Houston, TX 77054, as well as onsite attendance for meetings or additional training. Employees must permanently reside and work in Texas. UTHealth Houston does not provide lodging or mileage reimbursement for training.

Requirements

High school diploma or equivalent.
At least 3 years of experience in healthcare financial clearance, insurance verification, or a related revenue cycle role.
Must permanently reside and work in Texas.
Ability to maintain the security or integrity of critical infrastructure, where applicable to the position.

Nice To Haves

Associate's degree in a healthcare- or business-related field.

Responsibilities

Analyze benefit information and clinical documentation to confirm coverage and medical necessity under payer guidelines.
Perform registration components, including charge review, to support accurate patient registration and compliance with payer requirements before claim submission.
Obtain prior authorizations according to insurance policies and initiate Peer-to-Peer (P2P) reviews when needed.
Collaborate with clinical, scheduling, and financial teams to support financial clearance.
Communicate insurance benefits and cost estimates to patients and educate them about financial responsibilities.
Identify and update referral authorization numbers when applicable during charge review.
Enter and maintain insurance data in Epic based on real-time eligibility responses or payer portals, and select insurance plans in accordance with the UT Managed Care Payer Plan Tool.
Identify and report trends in denials, payer issues, and workflow inefficiencies to support continuous improvement and leadership decision-making.
Maintain compliance with HOOP policies, HIPAA, and payer guidelines.
Perform other duties as assigned.

Benefits

100% paid medical premiums for full-time employees.
Generous paid time off, including holidays, a preventative leave day, vacation, and sick time (approximately 37–38 days per year).
Increasing vacation accrual with longer service.
Monthly longevity payments after two years of service.
Retirement/pension plan.
Free financial and legal counseling.
Free mental health counseling services.
Gym membership discounts and access to wellness programs.
Employee discounts, including entertainment, car rentals, and cell phones.
Resources for child and elder care.