The Revenue Cycle Financial Clearance Specialist is a hybrid front- and back-end revenue cycle role that verifies insurance eligibility and benefits, obtains referrals and authorizations, and ensures patients are financially cleared before their date of service.
The position also resolves charge and claim edits in NextGen and Availity RCM, helps build and maintain rules in RCx to prevent recurring errors, and supports claim follow-up, denials, and payment posting.
This role works closely with practices, clinics, the business office, payors, and patients to reduce rework, track edit and denial trends, and recommend process improvements. The specialist follows company policies and procedures, including verification timeliness and out-of-network scheduling, and maintains strict HIPAA confidentiality.
3+ years of experience in medical insurance verification, patient financial clearance, or revenue cycle operations
3+ years of experience with PCP referrals and prior authorizations
2+ years of experience working claim edits, rejections, or denials in a practice management system or clearinghouse
Preferred experience with NextGen, Availity (including Availity RCM), Rivet, and RCx
Preferred experience building or maintaining claim scrubber or rules-engine logic
Location
Texas, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
3 weeks ago