Financial Clearance Coordinator

The Financial Clearance Center supports patients, providers, and payors by facilitating financial clearance activities, insurance verification, authorization management, financial counseling, and clinical documentation review to help ensure timely access to care.

About the role

The Financial Clearance Coordinator plays a critical role in coordinating clinical and financial clearance processes while supporting patients throughout their care journey. As part of UT MD Anderson, the coordinator applies clinical expertise and sound judgment to support medical necessity reviews, authorization activities, peer-to-peer engagement, and financial counseling. The role collaborates with patient access teams, payors, third-party vendors, and clinical staff to resolve barriers to care, ensuring timely and accurate financial clearance while contributing to the organization's mission of exceptional patient care.

Responsibilities

• Documentation & Authorization Processing
  • Obtain and document verification of patient eligibility and applicable effective dates using institutional systems, payor systems, web portals, and available tools within established departmental timeframes.
  • Notify Patient Access and patients when eligibility information is invalid or cannot be verified.
  • Obtain and document verification of patient benefits, including product type, network status, co-payments, deductibles, co-insurance amounts, pre-existing condition indicators, and lifetime or annual maximums.
  • Enter accurate eligibility and benefits information into the electronic health record in a timely manner.
  • Manage worklists for cases requiring pre-authorization and coordinate directly with payors or assigned third-party vendors.
  • Obtain required pre-authorizations through online portals and available authorization tools whenever possible.
  • Accurately document authorization numbers, reference numbers, payor contacts, and authorization outcomes in the electronic health record.
  • Maintain complete and accurate documentation of all communications with patients, payors, vendors, Patient Access personnel, and other stakeholders.
• Clinical Review & Medical Necessity Support
  • Apply clinical knowledge and professional judgment to support pre-authorization activities.
  • Assist associates when clinical interpretation, medical necessity justification, and clinical review are required.
  • Support peer-to-peer engagement activities related to authorization and utilization review processes.
  • Assess and interpret patients' clinical conditions to facilitate timely resolution of financial clearance issues.
  • Stay current with appropriate clinical documentation requirements and professional publications.
• Clinical Trial & Coverage Review
  • Review clinical trial participation details and identify services covered by trial sponsors.
  • Document services designated for sponsor coverage and those designated for patient insurance coverage.
  • Communicate coverage responsibilities appropriately with patients and payors.
  • Ensure accurate documentation of clinical trial-related financial clearance activities.
• Financial Counseling & Customer Collaboration
  • Provide financial counseling to patients regarding estimated costs and expected financial responsibility.
  • Assist with calculating patient liability including co-payments, deductibles, and co-insurance obligations.
  • Discuss payment requirements, available payment plan options, and patient financial assistance opportunities when applicable.
  • Review Advance Beneficiary Notices (ABN), Medicare Secondary Payer Questionnaires (MSPQ), 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.
  • Answer emails and phone calls promptly and respond to voicemails and in-basket messages within one business day.
  • Maintain professional and courteous relationships with patients, physicians, payors, vendors, and business partners.
• Operational Excellence & Professional Development
  • Promptly escalate financial clearance or counseling issues to the Financial Clearance Supervisor when appropriate.
  • Seek assistance from Financial Clearance Coordinators when additional support is needed.
  • Complete and submit required documents, including PFA and COBRA-related documentation, requiring supervisor approval.
  • Participate in educational, training, and mentoring opportunities to enhance performance and professional growth.
  • Perform all other duties as assigned.

Requirements

• Education
  • Required: Graduation from an accredited school of nursing.
• Work Experience
  • Required: Two years experience in nursing, or one year related nursing experience in utilization review, insurance, case management, or medical clearance.
  • Preferred: 2 years oncology nursing experience.
  • Preferred: 2 years experience in utilization review with external payors within a hospital or insurance setting.
  • Preferred: Research, clinical trial knowledge, and authorization experience.
• Licenses and Certifications
  • Required: RN - Registered Nurse - State Licensure (State of Texas Professional Nursing license).
  • Required: BLS - Basic Life Support or CPR - Cardiac Pulmonary Resuscitation upon hire.
  • Preferred: CCM - Certified Case Manager (Commission for Case Manager Certification).
  • Preferred: CHAM - Certified Healthcare Access Manager (National Association of Healthcare Access Management).
  • Preferred: ACLS - Advanced Cardiac Life Support (as required by patient care area).
  • Preferred: PALS - Pediatric Advanced Life Support (as required by patient care area).

Pay

Salary Range (Annual): Minimum $89,000.00 - Midpoint $111,000.00 - Maximum $133,000.00
Hourly Equivalent (40-hour work week): Minimum $42.79 - Midpoint $53.37 - Maximum $63.94

Schedule

Monday - Friday, 8:00 AM - 5:00 PM.

Benefits

• Employer-paid medical coverage starting day one for employees working 30+ hours/week, plus optional group dental, vision, life, AD&D, and disability insurance.
• Accruals for Paid Time Off (PTO) and Extended Illness Bank, plus paid holidays, wellness, childcare, and other leave options.
• Tuition Assistance Program after six months of service and access to extensive wellness, fitness, and employee resource groups.
• Defined-benefit pension through the Teachers Retirement System, voluntary retirement plans, and employer-paid life and reduced salary protection programs.

Work Location: Remote but must be able to come onsite as needed.