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FINANCIAL CLEARANCE MANAGER

Company: UMass Memorial Health Care
Location: Worcester
Posted on: December 8, 2018

Job Description:

Requisition # 190361

Title: Manager, Financial Clearance

Department: Patient Access Services

Posting Date: Oct 26, 2018

Status: Exempt

Shift: Days

Hours: 40

Location: UMass Memorial Health Care - 67 Millbrook St, Worcester, MA

$1000 SIGN-ON BONUS

UMass Memorial Health Care is the largest health care system in Central Massachusetts. We are the clinical partner of UMass Medical School, with access to the latest technology, research and clinical trials. Our health care system includes four hospitals:


  • UMass Memorial Medical Center (Worcester)
  • UMass Memorial HealthAlliance-Clinton Hospital (Clinton, Fitchburg and Leominster)
  • Marlborough Hospital (Marlborough)

    In addition to our fully equipped medical centers, our system also includes home health and hospice programs, behavioral health programs and community-based physician practices.

    Position Summary:

    Under the general direction of the Director of Financial Clearance, manages the daily operation of assigned area within Patient Access Services. Performs a variety of complex duties and management of Financial Clearance and/or registration personnel and activities to ensure the efficient processing of patients and collection of patient liabilities. Coordination of daily activities for Patient Access Services, including but not limited to scheduling of staff, maintenance of work queues, and statistical reporting.

    Position Qualifications:

    License/Certification/Education:

    Required:

    • Bachelor's Degree in Business, Healthcare or related field.
    • Minimum of 2 years' managerial experience in Registration, Scheduling, and/or Insurance Verification processes required;
    • Flexibility of schedule required.
    • Holiday and/or weekend shift work, as well as after-hours coverage as required.

      Preferred:

      • 7-10 years of Healthcare management experience preferred.

        Experience/Skill:

        Required:

        • Demonstrated leadership ability, initiative, teamwork and assertiveness required.
        • Excellent communication and analytical skills.
        • Strong organization skills.
        • Excellent interpersonal skills.
        • Demonstrated expertise in area of responsibility as well as the ability to solve complex problems.
        • Complete understanding of third party payor and managed care requirements, procedures and regulations.
        • Complete understanding of primary, secondary and tertiary insurance requirements, procedures and regulations.
        • Face-to-face and telephone customer service skills and experience.
        • Ability to effectively communicate with a variety of internal and external customers
        • Ability to receive and express detailed information through oral and written communications
        • Ability to work in high volume, team-oriented environment
        • Ability to take directions and work independently.
        • Ability to use specialized applications software and computers systems for patient registration and scheduling.

          Major Responsibilities:

          • Designs, monitors and implements registration, referral and verification guidelines, as well as collection of patient liabilities to ensure an accurate and efficient process for Patient Access Services.
          • Ensures scheduling verification, referral and pre-arrival registration processes are integrated and accurate information flows on a timely basis.
          • Sustains the Avaya (call center server application) service level standards by monitoring and analyzing volume and staffing levels and making adjustments as required.
          • Works closely with ambulatory services senior management, physicians, clinical leaders and other departments to ensure harmonious relationship and atmosphere of teamwork.
          • Oversees and monitors work queues and reports for Patient Access Services.
          • Monitors the registration and financial clearance process to ensure high quality customer service.
          • Ensures the financial clearance process is completed timely and accurately prior to patient arrival whenever possible.
          • Monitors work queues and reports to ensure follow-up when financial clearance is not obtained prior to patient arrival.
          • Manages work queues and reports to ensure appropriate productivity and quality standards are achieved.
          • Manages all applicable escalation work queues.
          • Oversees collection of patient liabilities as appropriate.
          • Position is a working managerial position. May act as Patient Access Representative, Financial Clearance Representative, and/or Registration Representative when necessary.
          • Ensures compliance with EMTALA regulations (Emergency Medical Treatment and Labor Act)
          • Ensures that department complies with UMMHC established policies, quality assurance programs, safety, and infection control policies and procedures.
          • Ensures adequate equipment and supplies for department
          • Assists Director in development and maintenance of departmental policies, procedures and objectives.
          • Finalizes, signs off and submits payroll on a weekly basis as applicable.
          • Ensures compliance to all health and safety regulations and requirements.
          • Ensures strict standards of patient confidentiality are met.
          • Organizes and maintains clear channels of communication with staff.
          • Exhibits appropriate communication with all levels of personnel.

            Standard Management Level Responsibilities:

            • Directs and supervises assigned personnel including performance evaluations, scheduling, orientation, and training. Makes recommendations on employee hires, transfers, promotions, salary changes, discipline, terminations, and similar actions. Resolves grievances and other personnel problems within position responsibilities.
            • Develops and recommends the budgets for the areas managed. Manages activities to assure financial goals are met.
            • Coordinates the assignment of tasks and helps resolve technical and operational problems. Evaluates the impact of solutions to ensure goals are achieved.
            • Provides effective direction, guidance, and leadership over the staff for effective teamwork and motivation, and fosters the effective integration of efforts with system-wide initiatives.
            • Encourages and supports diverse views and approaches, creating an environment of professionalism, respect, tolerance, civility and acceptance toward all employees, patients and visitors.
            • Integrates diversity into departmental objectives, such as hiring, promotions, training, vendor selections, etc.
            • Participates in performance improvement initiatives and demonstrates the use of quality improvement in daily operations.
            • Ensures compliance with regulatory agencies such as Joint Commission, DPH, etc. Develops and maintains procedures necessary to meet regulatory requirements.
            • Ensures that department complies with hospital established policies, quality assurance programs, safety, and infection control policies and procedures.
            • Ensures adequate equipment and supplies for department.
            • Develops and maintains established departmental policies, procedures, and objectives.
            • Ensures compliance to all health and safety regulations and requirements.
            • Maintains, regular, reliable, and predictable attendance.
            • Performs similar or related duties as required or directed.

              All responsibilities are essential job functions.

              Keywords: UMass Memorial Health Care, Worcester , FINANCIAL CLEARANCE MANAGER, Executive , Worcester, Massachusetts

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