Financial Access Manager
4 weeks ago
**Financial Access Manager**
- (3293184)
Under direction of the Ambulatory Director of Operations, the Financial Access Manager is responsible for daily operations and smooth coordination of patient referral information within the Centralized Financial Access unit while supporting the Spaulding Rehabilitation Network (SRN) admissions financial clearance process for patients referred from multiple sources. Responsible for smooth coordination of workflows including insurance verification, prior authorization, rate negotiations and work queue management. Manager acts as knowledgeable resource and problem-solver for the Patient Service Representative, Medical Service Representatives, and Financial Access Specialist in the ambulatory insurance authorization group. Responsible for the staffing and management of daily activities to produce successful outcomes of all patient admission encounters.
The Manager integrates department's services with the hospital's primary functions to facilitate ease of access to services provided by facility, develops/implements policies and procedures that guide or support services, and assesses and improves department performance. Addresses and initiates process improvements and new workflow management within the SRN Financial Access team. The Financial Access Manager is responsible for acting as a technical epic resource and super-user, assisting front and back-end departments involved throughout Revenue Cycle Operations (RCO). Manager effectively provides leadership, guidance, support, direction, focus, coaching and performance management for staff, escalation of workflow issues, addresses staffing concerns and flags patients identified as financial risks requiring immediate escalation to Sr. Leadership for timely resolution.
**Responsibilities**:
- Use/s the Mass General Brigham values to govern decisions, actions, and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration.
- Interview, hire, evaluate, and counsel PRS and MSR financial access staff and perform evaluations in timely manner. Supervise and train new employees in all aspects of assigned jobs and maintain productivity. Provide leadership needed to promote a teamwork environment and ensure orientation and continuing education of staff. Communicate changes to existing employees. Create training materials and manage on-line access and admin capabilities to all online and information systems being utilized.
- Ensure smooth daily department operations. Ability to make independent decisions when necessary to financially clear patients for services without escalating to Ambulatory Director of Operations in order to prevent further delays of services.
- Work closely with SRN leadership to coordinate financial clearance process for ambulatory patients referred to SRN -Spaulding Rehabilitation Charlestown (SRH), Spaulding Cape Cod (SCC), and Spaulding Hospital for Continuing Medical Care at Cambridge (SHC). Notify sites of financial issues that may impact decision to accept patient. Monitor prioritization of insurance clearance to facilitate an expedient referral process. Escalate to payers and delegate duties, as necessary. Maximize timely and efficient completion to reduce delays in filing deadlines.
- Responsible for promoting positive customer service and developing and maintaining positive relationships with referral sources and managed care companies. Responsible for promoting positive customer service with patients and families and ensure benefit and authorization related questions are answered when calls received, or calls are redirected to FAS by SRN Admitting Offices.
- Act as point person for SRN Ambulatory sites on insurance coverage changes, coordination of benefit (COB) issues, and re-verification of benefits. Assist with adding coverage and reaching out to the appropriate Central Billing Office (CBO) contact when ambulatory FAS staff unable to add new coverage when accounts are interim-billed or billed.
- Act as point person for FAS staff, SRN ambulatory sites for Epic technical issues and questions pertaining to Financial Clearance process, as well as general epic questions, some of which may require immediate attention and resolution due to Epic hard-stops and Admitting Offices being unable to admit the patient after patient has arrived.
- Communicate process and workflow changes to existing employees and other departments directly impacted. Create training materials and tip-sheets for Financial Access Department when new processes or programs are utilized, set up team meeting walk-throughs and trainings as needed, and provide ongoing support once implemented. Manage on-line access and administrator capabilities to all online portals and information syste
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