Clinicalhealthnetworkfortransformation57mo ago

USD 63000–91000/yr

Financial Verification Manager

RemoteFull-Timemid

OtherManager

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Overview

The vision of Clinical Health Network for Transformation (CHN) is to support the mission and promise of Planned Parenthood to bring high-quality, affordable care to every member of our communities. CHN is a collaboration between Planned Parenthood affiliates across the United States.

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The vision of Clinical Health Network for Transformation (CHN) is to support the mission and promise of Planned Parenthood to bring high-quality, affordable care to every member of our communities. CHN is a collaboration between Planned Parenthood affiliates across the United States.

CHN is looking for individuals who are committed to supporting our shared goal of strengthening and enhancing our awareness and commitment to advancing the cause of health equity in our organization.

Reporting to the Director Patient Access, the Financial Verification Manager for Clinical Health Network for Transformation (CHN) is responsible for the oversight of the financial verification process. Supervises the team who performs financial clearance and insurance inquiry services for the following functions: preauthorization procurement, proactive financial coverage screening, complex insurance questions & benefits verification, and complex self-pay estimates. The Financial Verification Manager ensures the review and interpretation of denial reports, manual insurance verification reports, authorization review and procurement worklists, and all other reports, as necessary.

This position has an overall high-level responsibility for resolution of problems related to financial clearance as well as personnel activities including hiring, training, and development of assigned staff. The Financial Verification Manager will act as a single point of contact for initial communication with interdependent functions within Revenue Cycle and Patient Access. As such, they are responsible for facilitating bidirectional communication between frontline staff, Revenue Cycle, Patient Access Center, and leadership.

Supervises a Financial Verification Supervisor and a team of Financial Verification Specialists to ensure all administrative and technical functions of financial verification are being handled efficiently and effectively

Maintain competence to resolve direct consumer interactions; some interactions may include the following: determine eligibility for services, provide price estimates and/or guarantees for scheduled services, create and maintain payment plans, field inquiries about statements and Explanations of Benefits (EOB), provide financial assistance, address patient complaints

Ensure the financial verification team is appropriately staffed with trained employees

Serve as a liaison with the patients, providers, and payers related to financial verification issues

Act as an advocate for the patient, provider, and CHN relative to compliance with federal, state, and third-party regulatory requirements

Demonstrate an elevated level of integrity and innovative thinking and actively contribute to the success of the organization

Participate in the development and implementation of CHN’s improvement and operations initiatives

Measure and coach on departmental productivity, performance, and improvement opportunities

Hire, direct, coach, and check the performance of all direct reports, to develop and support a high-performance team that meets organizational and department goals

Problem-solve escalated concerns from CHN member affiliate health centers and/or patients

Drive innovation with our front-end method and processes to lower operational costs and improve AR (Accounts Receivable), transaction times, screening rates, and approval rates with our affiliate partners

Work with CHN leadership in development of short- and long-term business and strategic plans and organizational structure within the Patient Access center

Execute efforts to drive financial clearance activities toward data driven operations

Work and build trust across cultural differences

Creates and promotes a culture of continuous improvement

Ensures compliance with all CHN and affiliate policies, as well as all state and federal regulations

Demonstrates a commitment to CHN and Planned Parenthood’s mission related to health equity, especially centering racial equity, and deep sense of accountability to community

Demonstrates a commitment to learning about and enhancing practices related to racial equity and the impact of structural racism on healthcare systems

Supplies positive and development feedback and accountability related to practices including, but not limited to, equity

The above duties and responsibilities are not an exhaustive list of required responsibilities, duties, and skills. Other duties may be added, and this job description can be amended at any time.

Bachelor’s degree and/or higher-education level or completed coursework in business or health services administration, or equivalent experience

3 years of Revenue Cycle experience with a specialized focus on Financial Clearance

Proven experience with staff recruiting and management

Strong and broad understanding of Revenue Cycle Operations within a healthcare setting

Mathematical/analytical aptitude, ability to translate operational concepts into measurable results, and vice versa

Strong communications and leadership skills, while acting as a role model and coaching team members

Strong analytical and problem-solving abilities

Proficiency with Microsoft software (Excel, etc.)

Demonstrated ability to maintain a customer-centric service approach

Excellent written and verbal communication skills and ability to collaborate and interact with all levels within and outside of CHN, if necessary

Strong attention to detail and follow-up; and ability to effectively prioritize deliverables

Demonstrated dedication to Planned Parenthood’s mission, vision, and values

Strong interpersonal skills and the ability to build relationships

Excellent time management and problem-solving skills

Willingness to travel in accordance with the needs of the position, as outlined in the essential functions. Compliance with all CHN travel policies, including safety guidelines while operating a personal vehicle

Master’s degree in business administration, healthcare management, or in a related field or equivalent experience

7+years of relevant experience at the management level

Experience providing training and coaching in both virtual and in-person settings for individuals and small groups

Commitment to advancing race(+) equity in one’s work: interested in expanding knowledge about the role that racial inequity plays in our society.

Awareness of multiple group identities and their dynamics, bringing a high level of self-awareness about personal identity, empathy, and humility to interpersonal interactions.

Demonstrated ability to communicate clearly and directly as well as hear and act on feedback related to identity and equity with the aim to learn.

Strong sense of accountability to equitable practices.

Understanding of the impact of identity dynamics on organizational culture.

Commitment to CHN and Planned Parenthood’s In This Together service ethos, workplace values, and service standards.