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Job Summary
The Manager, Financial Clearance, is responsible for supervising the Financial Clearance and Resource Assistance team, as needed, throughout UMC campuses.
Reports to
Director Financial Clearance and Counseling
Job Specific Responsibilities
Daily assignments may include but are not limited to:
• Update prior authorization requirements timely based on changes with insurance companies and educate team members on those changes and requirements.
• Manage Post Acute Care team that handles authorization for SNF, LTACH, and IPR transfers.
• Manages and assists the Cancer Center Authorization team.
• Helps manage the Resource Assistance team, as needed.
• Communicate with other hospital departments, insurance companies, and at times, patient’s family members to ensure continuity of care for reoccurring appointments, financial responsibility, and to ensure facility receives accurate reimbursement for services provided.
• Understanding and timely correction of account edits and knowledge to clear the error to ensure timely billing.
• Expertise in Out of Network and Uninsured/Underinsured health insurance coverage to ensure accurate communication with patients, guarantors, and providers and to follow UMC policies and workflows.
• Establish and maintain adequate staffing levels to ensure accounts are accurately reviewed and cleared.
• Hire, train/education, and evaluate staff and provide timely coaching feedback including progressive disciplinary action.
• Complete performance appraisals withing timeline expectations set for by leadership.
• Review/Audit individual staff performance related to quality and quantity of work to identify training issues and re-educate as necessary.
• Manage department/team within the established annual department budget.
• Assist the Director in developing the Operating and Capital budgets.
• Onboard and orient all new hires and ensure the department checklist is completed within the 90-day probationary period and filed in the employees’ HR file.
• Perform Financial Clearance duties when short-staffed or necessary.
Education and Experience
• Bachelor’s degree in a Business-related field + 1 year of experience Patient Access, Patient Financial Services, or other applicable healthcare financial experience.
OR
• +10 years Patient Access/Patient Financial Services experience, plus two years management.
Required Licensures/Certifications/Registrations
• HIPAA Certification
Knowledge, Skills and Abilities
• Prior Epic experience preferred.
• Operational knowledge of PC and mainframe system.
• Expertise in all Microsoft Outlook Applications.
• Ability to analyze reports and detect operational issues, opportunities and design recommendations and prepare synopsis for the Director’s review and approval.
• Communicate concisely in verbal and written formats as appropriate for the audience.
• Possess strong analytical and quantitative skills as well as positive interpersonal skills.
• Possess a change oriented/innovative attitude.
• Knowledge of Medical Record Coding is helpful.
Interaction with Other Departments and Other Relationships
Internal: Interacts with patients, visitors, family members, and staff of all hospital departments within UMC
External: UMC Physicians, Texas Tech Physicians, and other external clinics with physician privileges at UMC
Physical Capabilities
Visual and auditory acuity are required continuously. The ability to speak is required frequently. The ability to sit for extended periods is required frequently. Typing is required continuously. Lifting/carrying requirements are light but may occur moderately. The ability to walk/transport oneself in a timely manner is required frequently.
Environmental/Working Conditions
The position is indoors and not prone to hazardous materials but may experience constantly changing indoor temperatures. Workdays are Monday through Friday, 8 a.m. to 5 p.m. but occasional nights and weekends may be required.
Direct Reports
Financial Clearance Team
UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
*Request for accommodations in the hire process should be directed to UMC Human Resources.*