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.
Bachelors in Business or related field OR combination of equivalent education and experience (Required)
Five (5) years of management and/or leadership experience. (Required)
Seven (7) years of related healthcare experience, which includes a minimum of two (2) years of experience in a hospital and professional registration, insurance verification and authorization, financial counseling department. (Required)
AMPFM or Misys platform experience. (Preferred)
Ability to work effectively in a high-volume, fast-paced environment with changing priorities. (Required)
Must possess customer-focused attitude and professional demeanor. (Required)
Analytical skills associated with generating productivity and other related reports. (Required)
Knowledge of CPT/ICD-9 codes and an understanding of medical terminology and HIPAA privacy laws. (Required)
Strong/effective oral and written communication and problem-solving skills. (Required)