Financial Clearance Specialist III - Revenue Cycle

%3Cp%3E%3Cstrong%3EWhat we do here changes the world.%3C/strong%3E UTHealth Houston is Texas’ resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That’s where you come in.%3C/p%3E%3Cp class=%22elementtoproof%22 style=%22-webkit-text-stroke-width:0px;background-color:white;color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 9pt;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cspan style=%22color:rgb(222,106,25);%22%3E%3Cstrong%3EUTHealth is seeking a highly motivated, experienced Financial Clearance Specialist III (Remote) to join our dynamic referral team. This team plays a critical role in ensuring that any referrals sent from outside hospitals to UTHealth physicians are processed efficiently and accurately. Working in a high-volume call center environment, you will be the first point of contact for patients referred to our doctors, ensuring a seamless experience from referral to scheduling.%3C/strong%3E%3C/span%3E%3C/p%3E%3Cp class=%22elementtoproof%22 style=%22-webkit-text-stroke-width:0px;background-color:white;color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 9pt;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cspan style=%22color:rgb(222,106,25);%22%3E%3Cstrong%3EKey Responsibilities:%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul style=%22-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:12px 0px;orphans:2;padding:revert;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:rgb(222,106,25);font-family:%26quot;Open Sans%26quot;, sans-serif;%22%3E%3Cstrong%3EVerify medical insurance coverage for all referred patients.%3C/strong%3E%3C/span%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:rgb(222,106,25);font-family:%26quot;Open Sans%26quot;, sans-serif;%22%3E%3Cstrong%3EContact patients directly to obtain and confirm insurance information.%3C/strong%3E%3C/span%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:rgb(222,106,25);font-family:%26quot;Open Sans%26quot;, sans-serif;%22%3E%3Cstrong%3ECoordinate referrals from external hospitals to UTHealth physicians.%3C/strong%3E%3C/span%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:rgb(222,106,25);font-family:%26quot;Open Sans%26quot;, sans-serif;%22%3E%3Cstrong%3EDeliver exceptional customer service by guiding patients through the process until they are scheduled with their referred doctor.%3C/strong%3E%3C/span%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:rgb(222,106,25);font-family:%26quot;Open Sans%26quot;, sans-serif;%22%3E%3Cstrong%3EMaintain efficiency and accuracy in a fast-paced, high-volume environment.%3C/strong%3E%3C/span%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:rgb(222,106,25);font-family:%26quot;Open Sans%26quot;, sans-serif;%22%3E%3Cstrong%3ECollaborate with clinical and administrative teams to resolve any insurance or referral issues%3C/strong%3E%3C/span%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cp class=%22elementtoproof%22 style=%22background-color:white;margin:0px 0px 9pt;%22%3E%3Cspan style=%22color:rgb(222,106,25);%22%3E%3Cspan%3E%3Cstrong%3ELocation: Remote (2- 4 weeks onsite for training @ 1851 Crosspoint Ave, 77054)%26nbsp;, meetings, additional training, etc.%3C/strong%3E%3C/span%3E%3C/span%3E%3C/p%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cp class=%22elementtoproof%22 style=%22background-color:white;margin:0px 0px 9pt;%22%3E%3Cspan style=%22color:rgb(222,106,25);%22%3E%3Cspan%3E%3Cstrong%3EMust live in Texas (TX).%26nbsp;This is a Remote position, and you must reside in Texas%3C/strong%3E%3C/span%3E%3C/span%3E%3C/p%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cp class=%22elementtoproof%22 style=%22background-color:white;margin:0px 0px 9pt;%22%3E%3Cspan style=%22color:rgb(222,106,25);%22%3E%3Cspan%3E%3Cstrong%3EMust be able to attend any required onsite meetings%3C/strong%3E%3C/span%3E%3C/span%3E%3C/p%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cp class=%22elementtoproof%22 style=%22margin:0px 0px 12px;%22%3E%3Cspan style=%22color:rgb(222,106,25);%22%3E%3Cspan%3E%3Cstrong%3EWe DO NOT provide lodging or mileage reimbursement for training%3C/strong%3E%3C/span%3E%3C/span%3E%3C/p%3E%3C/li%3E%3C/ul%3E%3Cp class=%22elementtoproof%22 style=%22margin:0px 0px 12px;%22%3E%26nbsp;%3C/p%3E%3Cp%3E%3Cstrong%3EOnce you join us you won%27t want to leave.%3C/strong%3E It’s because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you’d expect from a top healthcare organization (benefits, insurance, etc.), plus: %26nbsp;%3C/p%3E%3Cul%3E%3Cli%3E100% paid medical premiums for our full-time employees %26nbsp;%3C/li%3E%3Cli%3EGenerous time off (holidays, preventative leave day, both vacation and sick time – all of which equates to around 37-38 days per year)%26nbsp;%3C/li%3E%3Cli%3EThe longer you stay, the more vacation you’ll accrue!%26nbsp;%3C/li%3E%3Cli%3ELongevity Pay (Monthly payments after two years of service)%26nbsp;%3C/li%3E%3Cli%3EBuild your future with our awesome retirement/pension plan!%26nbsp;%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3EWe take care of our employees!%3C/strong%3E As a world-renowned institution, our employees’ wellbeing is important to us. We offer work/life services such as...%26nbsp;%3C/p%3E%3Cul%3E%3Cli%3EFree financial and legal counseling%26nbsp;%3C/li%3E%3Cli%3EFree mental health counseling services%26nbsp;%3C/li%3E%3Cli%3EGym membership discounts and access to wellness programs%26nbsp;%3C/li%3E%3Cli%3EOther employee discounts including entertainment, car rentals, cell phones, etc.%26nbsp;%3C/li%3E%3Cli%3EResources for child and elder care%26nbsp;%3C/li%3E%3Cli%3EPlus many more!%26nbsp;%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3EPosition Summary:%3C/strong%3E%3C/p%3E%3Cp%3EThe RCM Financial Clearance Specialist III position is a key leader within the Revenue Cycle team, responsible for advanced-level insurance verification and authorization functions. This role ensures timely and accurate financial clearance of patient services by securing insurance benefits, prior authorizations, and referrals. The Senior Specialist demonstrates strong analytical ability to resolve complex authorization issues, identify trends, and support process improvements. Additionally, this position acts as a resource and trainer for junior team members, contributing to departmental performance and compliance.%3C/p%3E%3Cp%3E%3Cstrong%3EPosition Key Accountabilities:%3C/strong%3E%3C/p%3E%3Cul%3E%3Cli%3EOversee comprehensive verification of insurance and benefit coverage, including accurate entry of patient demographics and insurance details, inclusive of charge review functions. Secure and document prior authorizations and referrals based on clinical documentation and payer guidelines. Evaluate insurance policies for medical necessity and initiate Peer-to-Peer (P2P) reviews or appeals for escalated or denied cases.%3C/li%3E%3Cli%3EEnsure precise documentation of insurance data within Epic, including plan selection validation using the UT Payor Tool. Monitor and report trends in denials, payer issues, and workflow gaps. Consistently meet or exceed quality, productivity, and turnaround benchmarks as set by leadership.%3C/li%3E%3Cli%3EEffectively communicate with patients regarding insurance coverage, authorization status, and financial responsibility. Provide timely and accurate cost estimates. Collaborate with clinical, scheduling, and patient access teams to ensure coordinated and efficient service delivery.%3C/li%3E%3Cli%3EProvide guidance and training to junior team members on best practices in insurance verification, payer communications, and Epic documentation standards. Serve as a resource and role model within the team to promote continuous learning and operational consistency.%3C/li%3E%3Cli%3EMaintain strict compliance with HOOP policies, HIPAA regulations, and payer-specific requirements. Ensure all actions and documentation meet institutional, legal, and accreditation standards.%3C/li%3E%3Cli%3EPerforms other duties as assigned.%3C/li%3E%3C/ul%3E

Certification/Skills:

• None

Minimum Education:

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

Minimum Experience:

5 years of experience in insurance authorization, verification, or healthcare financial clearance preferred. Proven experience resolving complex insurance cases and mentoring or training staff 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. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code §117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R. §791.4.

Residency Requirement:

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

Job Details Primary Location: United States-Texas-Houston Work Locations: Operations Center Building, 1851 Crosspoint Avenue, Houston, 77054 Job: Professional/Managerial Organization: McGovern Medical School at UTHealth Houston Job Posting: Oct 28, 2026, 3:39:56 PM

High school diploma or equivalent required; 5 years insurance authorization/verification experience preferred; must reside in Texas; ability to attend onsite meetings; security-sensitive position.

Key Responsibilities

• verifying insurance coverage
• contacting patients
• coordinating referrals

Skills & Tools

Epic

Job Details

• Category: Healthcare Services - Allied Health
• Seniority: Mid Level
• Commitment: Full Time
• Workplace: Remote — Texas, United States
• Languages: English

Benefits

• Generous paid time off
• Retirement plan

About UTHealth Houston

A Texas resource for healthcare education, innovation, scientific discovery, and excellence in patient care. — Industry: Healthcare

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