Manager-Scheduling and Financial Clearance-8111

The Manager of Scheduling and Financial Clearance has general oversight of financial clearance functions.

This individual aids in setting goals, priorities, performance standards, policies, and procedures for the following functions: pre-registration, insurance/benefit verification, referrals, prior authorizations, any related denials, price estimations including the No Surprises Act, and central scheduling.

This individual ensures financial clearance is obtained prior to services being rendered, patient experience protocols are followed, and clearance is obtained in a timely manner to reduce related denials. This position has key responsibilities that directly impact reimbursement and the hospital’s financial performance.

This individual will be involved in departmental and interdepartmental process improvement teams to eliminate waste and improve efficiency. They will work closely with revenue cycle management to align revenue cycle processes to present a unified patient experience and consistent capture of data. Additionally, the position will work in conjunction with joint ventures, partnerships, and any additional community connect partners to ensure their needs are met.

Employee Management and Training

· Manages and develop Financial Clearance Supervisors, Central Scheduling Supervisors, and staff.

· Monitors staff engagement and implement ideas for improvements.

· Assists with interviews and making hiring decisions to maintain adequate staffing in the department.

· Provides timely performance improvement feedback and coaching.

· Responds to escalated employee issues/questions/concerns.

· Oversees the development of training materials and ongoing assessments; regularly review training materials to include new methodologies and concepts.

· Actively seeks and schedules staff development opportunities, including those outside the department that would be beneficial for staff members to attend.

· Identifies focus areas for competency assessments; provide training opportunities addressing areas highlighted by these assessments.

Development and Implementation of Policies and Procedures

· Develop, recommend, and implement policies and procedures for the department.

· Monitor adherence to policies and established procedures.

· Propose methods which assure effective execution of responsibilities.

· Update policy and procedure manuals as required.

· Apprise staff of changes.

· Ensure alignment with existing KHI policies and procedures.

Financial Performance:

· Holds themselves accountable for the results of the scheduling and financial clearance department (i.e., the number of days out that patients are scheduled for services and cleared financially, time-of-service collections, HCAHPS patient satisfaction scores related to scheduling and financial clearance, losses and write-offs related to authorizations not obtained and financial clearance not completed, and the accuracy of information collected and processed).

Education: Associates degree in Business and/or Healthcare related field, or 2 years equivalent, relevant work experience and training

Experience:

· Five (5) years’ experience in a healthcare setting or related industry

· Experience managing a team or working with people across functions and departments.

Knowledge, Skills, and Abilities:

· Proven track record in identifying and resolving problems related to people, process, and technology

· Analytical skills

· Ability to generate and interpret quantitative data, set goals, and monitor performance

· Written and verbal communication skills

· Ability to manage staff and communicate across departments and functions

· Ability to manage projects, work independently or with teams, and deliver on promises

Education: Bachelor’s degree business, healthcare administration, or related field

Experience: Experience in healthcare customer service

· Bloodborne disease exposure category: III: Expected duties do not have potential for exposure to blood, body fluids, or tissues

· Other Potential Hazard(s): Possible exposure to chemical substances

· Ability to sit for six to seven hours daily at a computer terminal

· Occasionally lifts and carries up to 15 pounds of files to storage area

· Must be able to deal calmly and effectively with frustrated and/or angry customers