Mgr, Pat Access Fncl Clearance

Location:

Telecommuting

Shift: Mon-Fri, Days, 8am-5pm

Category:
Director/Management

Employee Type:
Full-Time

The Manager of Patient Access Financial Clearance is responsible for planning, organizing, leading and directing the overall financial clearance functions, which includes pre-registration, payer authorization (outpatient and hospital) and financial counseling functions where applicable, for optimal performance of the front-end patient financial clearance process. In addition, the Manager oversees and is accountable for front-end data quality for the pre-registration, payer authorization (outpatient and hospital) and financial counseling activities for Patient Access scope of service.

Ensures an ongoing procedure for accurate and timely gathering of patient information, securing patient`s insurance coverage limits and benefits and communicating to patients for meeting the financial expectations of the hospital as applicable. Ensures that these functions are performed efficiently throughout the enterprise, which includes maintaining an adequately trained staff to handle all patients in both inpatient and outpatient clinic settings.

The manager must have a clear understanding of multiple managed care contracts, multiple specialty insurance and billing practices, and exercise professional competency in reviewing patient accounts to maximize reimbursement and minimize financial risk to Phoenix Children’s. Successful oversight will result in increased net revenues by reducing bad debt from potential write-offs due to lack of patient collections and denials. Interactions will primarily be conducted with both patients and payors and results of efforts will drive actions to secure payment for scheduled and unscheduled patients.

Serves as a resource to faculty, managers, and clinic staff in all financial clearance related issues.

Leadership/Management

• Provides effective leadership and manages appropriate staff levels. Develops goals and priorities and assigns tasks and projects.
• Develops staff skills and training plans.
• Counsels, trains and coaches assigned staff.
• Implements corrective actions and conducts performance evaluations.
• Provides leadership, direction and guidance.
• Represents the department on various committees.
• Responsible for designing, developing, and monitoring performance improvement processes such as but not limited to quality, accuracy, productivity and timeliness.
• Manages implementation of standards and systems to enhance quality, consistency, efficiency, and timeliness of responsibilities for the enterprise.
• Monitors to ensure that integrity and accuracy of registration data is maintained by the staff supervised.
• Works collaboratively with other departments to ensure the processes and systems for patient financial clearance processes are standardized and optimized for efficient and effective flow of patients within the department and the organization.
• In conjunction with Supervisors, ensures staff are scheduled appropriately and in accordance with volume and workflow indicators to ensure compliance with department goals.
• Manages daily operations of the Financial Clearance team to ensure optimal efficiency of workflow processes consistent with all applicable standards and regulations, and established policies and procedures.
• Develops and continually refines policies and procedures; i.e., No Surprise Act and Good Faith Estimate processes.
• Participates in the budget process and recommends appropriate purchase of equipment and systems.
• Monitors and trends Key Performance Indicators and Productivity and QA measures for the Financial Clearance and reports results, progress and recommendations to Director.
• Provides timely review and feedback to management team for fiscal responsibilities of designated areas, reflecting optimal use of all resources.
• Responsible for the supervision of a team of nurses who act as resources to resolve Authorization issues.

Subject Matter Expertise

• Ensures financial clearance functions are performed efficiently throughout the Patient Access services enterprise.
• Financial Clearance functions include but are not limited to, pre-registration tasks such as, insurance verification, insurance benefits data, regulatory requirements, securing payer authorizations, collecting payments for upcoming services to financially secure all applicable accounts.
• Oversees timely financial assistance application approval process consistent with state and federal requirements and…