Financial Care Coordinator II- Revenue Cycle

Financial Care Coordinator II

The Financial Care Coordinator II serves as an advanced financial navigator, managing complex patient financial cases across multiple specialties and service lines. This role requires a subject matter expert in financial clearance, benefit interpretation, complex estimates, payer requirements, and specialty workflows while mentoring team members and supporting process improvement initiatives. This role partners with providers, clinical departments, operational leadership, and revenue cycle teams to improve financial outcomes and deliver an exceptional concierge-level patient experience.

Join UTHealth Houston as a Financial Care Coordinator II and serve as an advanced financial navigator for patients with complex healthcare needs. This role provides expert financial counseling, insurance benefit review, cost estimates, authorization support, and financial clearance for specialty services. The ideal candidate will have 3+ years of progressive healthcare revenue cycle experience, including insurance verification, benefit interpretation, prior authorizations, financial counseling, and managing complex payer requirements. Join a collaborative team dedicated to delivering an exceptional patient experience while supporting financial transparency and operational excellence.

Position Key Accountabilities:

• Assists with managing complex patient financial cases by analyzing insurance benefits, coverage determinations, coordination of benefits, reimbursement methodologies, and payer requirements to support accurate financial clearance and resolution of coverage and billing issues.
• Prepares comprehensive patient cost estimates for complex surgical, procedural, diagnostic, and specialty services using verified insurance benefits, contractual allowances, and anticipated patient financial responsibility.
• Provides advanced financial counseling by educating patients and families on insurance coverage, financial obligations, payment options, financial assistance programs, and available resources to support informed healthcare decisions.
• Coordinates financial clearance for complex services by evaluating medical necessity, payer guidelines, benefit limitations, referral, authorization, and pre-certification requirements to facilitate timely access to care.
• Analyzes and resolve complex payer and reimbursement issues, coordinate escalations, assist with financial responsibility appeals, and advocate for appropriate coverage determinations to minimize patient financial burden.
• Provides knowledge sharing to Financial Care Coordinator staff, supports onboarding and training, and provides guidance on complex financial clearance, insurance, and regulatory matters.
• Partners with providers, clinic leadership, contracting, coding, referrals, authorizations, and revenue cycle departments to improve financial outcomes, standardize workflows, support process improvement initiatives, and enhance the patient financial experience.
• Adheres to departmental policies and procedures, revenue cycle standards, payer guidelines, organizational policies, and all applicable federal, state, and regulatory requirements to support compliant and effective financial operations.
• Maintains compliance with the No Surprises Act, Good Faith Estimate requirements, HIPAA, and all applicable federal, state, and organizational patient financial service regulations.
• Meets departmental productivity, quality, compliance, and customer service objectives.
• Performs other duties as assigned.

Certification/Skills:

• None

Minimum Education:

High School Diploma or equivalent required. Associate's Degree preferred.

Minimum Experience:

3 years of progressive experience in a healthcare setting performing insurance verification, benefit interpretation, financial counseling, price estimation, prior authorizations, patient access, or other revenue cycle functions, including experience managing complex insurance plans, payer requirements, specialty workflows, and financial clearance activities 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.