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Financial Clearance Operations Manager
2 months ago
POSITION SUMMARY:
The Financial Clearance Operations Manager plays a pivotal role in leading and supervising the daily operations of the Financial Clearance unit within the Patient Access Services (PAS) department. This position is integral in supporting the Director of Patient Access to realize the strategic objectives for the organization’s PAS and Financial Clearance initiatives. The manager ensures that supervisors are effectively conducting productivity and quality evaluations while providing necessary support to enhance team performance. It is essential that all financial clearance protocols are adhered to consistently. The areas under this role include Financial Clearance and Central Referral/Authorization.
KEY RESPONSIBILITIES:
- Oversee and manage the team's performance in relation to financial clearance tasks and established objectives, offering constructive feedback and guidance to supervisors and team members.
- Design, implement, and oversee operational policies, procedures, and performance metrics for Financial Clearance to ensure efficiency and effectiveness.
- Identify and execute strategies aimed at enhancing the overall Financial Clearance process.
- Ensure that supervisory staff consistently engage in performance monitoring activities.
- Manage follow-up processes with patients and referring physician offices in cases of eligibility failures, missing authorizations/referrals, or absent patient benefits for scheduled services.
- Monitor and manage the applicable PAS Key Performance Indicators (KPIs), developing action plans when performance does not meet established standards.
- Propose innovative approaches to boost productivity as necessary.
- Assist the Director of Hospital Patient Access in executing the strategic vision for PAS and implementing necessary changes to comply with payer and regulatory standards.
- Regularly evaluate the performance of direct reports, providing feedback to recognize effective performance and facilitate proactive improvement measures.
- Stay informed about regulatory and compliance updates that impact the area of responsibility, ensuring staff are educated and processes are adjusted accordingly.
- Assess daily workflow prioritization to ensure that metrics and benchmarks are consistently met.
- Collaborate with various departments to implement necessary changes to the Financial Clearance process.
- Deliver organized and comprehensive communication to management, senior leadership, and other departments regarding proposed changes, deficiencies, developments, and opportunities that may affect the organization.
- Provide exceptional service to all patients, family members, visitors, volunteers, and colleagues.
- Challenge existing practices; identify opportunities for process improvements and present recommendations and solutions to management. Engage in the organization's culture of continuous improvement by actively participating in and promoting the CCHC Pillars of Excellence.
QUALIFICATIONS:
- A Bachelor's degree is required; a Master's degree is preferred or an equivalent combination of education and experience.
- Three to five years of experience in patient access financial clearance operations, with a minimum of two years in a supervisory role.
- Comprehensive knowledge of third-party reimbursement and eligibility processes and regulations.
- Ability to assess personal performance against set goals.
- Demonstrated operational and organizational skills with a goal-oriented mindset.
- Understanding of complex corporate relationships and the ability to influence within such environments.
- Excellent communication, leadership, delegation, and interpersonal skills.
- Ability to thrive under pressure and manage multiple initiatives simultaneously; must be capable of working independently, prioritizing tasks, and meeting deadlines.
- Ability to effectively communicate with and present to a diverse range of CCHC and external stakeholders, including senior management and physicians, as well as outside vendors and consultants.
