Patient Financial Clearance Specialist – Hybrid Role

U.S. Dermatology Partners; Tyler (TX); Hybrid; USD 52,000 - 68,000; Full time

Job summary

U.S. Dermatology Partners is seeking a hybrid Revenue Cycle Financial Clearance Specialist in Tyler, TX. This role verifies eligibility and benefits, obtains referrals and authorizations, and ensures patients are financially cleared before service dates.

The candidate will resolve charge and claim edits in NextGen and Availity RCM, build and maintain RCx rules, and support denials and payment posting while collaborating with payer and provider teams.

Qualifications

• 3+ years in medical insurance verification, patient financial clearance or revenue cycle operations
• 3+ years with PCP referrals and prior authorizations
• 2+ years working claim edits, rejections or denials in a practice management system or clearinghouse
• NextGen, Availity (including Availity RCM), Rivet and RCx experience preferred
• Experience building or maintaining claim scrubber or rules-engine logic preferred

Responsibilities

• Verify eligibility and benefits information for accurate financial clearance.
• Obtain referrals and authorizations through Rivet, Availity, payor portals or direct contact.
• Set up COB, payment class and payor information in NextGen.
• Document verification findings and communications in patient accounts.
• Review charges and resolve claim edits and denials in NextGen and Availity RCM.
• Develop and test rules in RCx to automate corrections and prevent recurring edits.

Job description

U.S. Dermatology Partners is seeking a hybrid Revenue Cycle Financial Clearance Specialist in Tyler, TX. This role verifies eligibility and benefits, obtains referrals and authorizations, and ensures patients are financially cleared before service dates.

The candidate will resolve charge and claim edits in NextGen and Availity RCM, build and maintain RCx rules, and support denials and payment posting while collaborating with payer and provider teams.