Job Description

Job Description:

The Financial Pre-Services Director is highly skilled and experienced in preregistration, financial clearance, and prior authorization. This role oversees and leads the team responsible for all facets of preregistration processes, financial clearance procedures, and prior authorization operations. The Financial Pre-Services Director possesses strong leadership qualities, extensive knowledge of healthcare regulations, and a proven track record of implementing strategies to streamline administrative processes while maintaining compliance standards.Key Responsibilities· Develops and implements efficient preregistration processes to optimize patient flow and enhance the overall patient experience.· Oversees financial clearance activities, including insurance verification, eligibility determination, and upfront collections, to ensure accurate billing and timely reimbursement.· Leads the prior authorization team in obtaining necessary approvals for medical services and procedures, minimizing delays and denials.· Collaborates with internal departments, including revenue cycle management, clinical teams, and compliance, to establish best practices and ensure alignment with organizational goals.· Monitors key performance indicators (KPIs) and metrics to assess departmental performance and identify areas for improvement.· Stays abreast of regulatory changes, payer requirements, and industry trends affecting preregistration, financial clearance, and prior authorization processes.· Develops and maintains strong relationships with healthcare providers, vendors, payors, and other stakeholders to facilitate efficient communication and resolution of issues.· Implements training programs and provide ongoing education to staff members to ensure proficiency in registration protocols, insurance procedures, and authorization requirements.· Drives initiatives to enhance revenue cycle efficiency, reduce denials, and maximize reimbursement for services rendered.· Fosters a culture of accountability, teamwork, and continuous improvement within the department.· Implements and monitor automation performance throughout Preservice to improve speed of execution and reduce total costRequired Qualifications· 5 years of progressive experience in healthcare administration, with a focus on patient registration, financial clearance, and prior authorization.· Strong understanding of healthcare regulations, including HIPAA, Medicare, and Medicaid guidelines.· Extensive knowledge of payer requirements and reimbursement policies, with experience in managing vendor relationships and negotiating contracts.· Excellent leadership skills with the ability to inspire and motivate teams to achieve departmental goals.· Exceptional communication and interpersonal abilities, with the capacity to effectively interact with diverse stakeholders, including insurance companies, vendors, and healthcare providers.· Proven track record of implementing process improvements and achieving measurable results.Preferred Qualifications· Master’s degree preferred.· Experience working with healthcare revenue cycle management systems and prior authorization software applications is preferred.

Education Qualifications:

Bachelor’s degree in healthcare administration, business administration, or a related field.

Licensure/Certification Qualifications:

No certification/licensure required.

Job Location: Business Service Center

Shift Rotation: Day Rotation (United States of America)

Shift Start/End: 0800/

Hours Per Pay Period: 80

Compensation Range:

Union:

FTE: 1

Weekends:

Call Obligations:

Sign On Bonus:

Equal Employment Opportunity (EEO) at Essentia

It is our policy to afford EEO to all individuals, regardless of race, religion, color, sex, pregnancy, gender identity, national origin, age, disability, family medical history, genetic information, sexual orientation, marital status, military service or veteran status, culture, socio-economic status, status with regard to public assistance, and other factors not related to qualifications, including employees or applicants who inquire about, discuss, or disclose their compensation or the compensation of other employees or applicants, or membership or activity in a local human rights commission, or any other category as defined by law.