Director, Financial Clearance

Overview

Be inspired. Be rewarded. Belong. At Emory Healthcare.

At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide :

• Comprehensive health benefits that start day 1
• Student Loan Repayment Assistance & Reimbursement Programs
• Family-focused benefits
• Wellness incentives
• Ongoing mentorship, development, and leadership programs
• And more

Description

The Director of Financial Clearance will lead the financial clearance department within Emory Healthcare, ensuring accurate and timely verification of patient insurance eligibility, prior authorizations, and financial arrangements prior to the delivery of healthcare services.

This role requires a strategic leader with a strong understanding of healthcare finance, insurance processes, and regulatory compliance.

The Director will collaborate with clinical, operational, and billing teams to optimize financial clearance processes and enhance the patient experience.

Key Responsibilities :

1. Leadership and Strategy :

• Oversee and manage the financial clearance team, fostering a high-performance culture focused on excellence and efficiency.
• Develop and implement strategies to streamline financial clearance processes and improve overall workflow.

2. Insurance Verification and Prior Authorization :

• Ensure accurate verification of patient insurance eligibility and coverage details.
• Oversee the prior authorization process, working closely with clinical staff to obtain necessary approvals in a timely manner.

3. Collaboration and Communication :

• Work in partnership with clinical, billing, and revenue cycle teams to ensure seamless financial clearance and patient registration processes.
• Serve as a point of contact for insurance companies and external stakeholders regarding financial clearance matters.

4. Compliance and Regulatory Oversight :

• Ensure adherence to all federal, state, and local regulations pertaining to financial clearance and insurance verification.
• Stay informed about changes in healthcare laws and insurance policies that may impact financial clearance operations.

5. Data Analysis and Reporting :

• Analyze financial clearance metrics to identify trends, areas for improvement, and operational efficiencies.
• Prepare and present regular reports on financial clearance performance to senior management.

6. Training and Development :

• Develop and implement training programs for staff to enhance knowledge of insurance processes, financial clearance best practices, and customer service skills.
• Promote a culture of continuous improvement, ensuring staff are equipped to handle evolving healthcare financial challenges.

Qualifications :

• Education : Bachelors degree in Healthcare Administration, Finance, Business Administration, or a related field; Masters degree preferred.
• Experience : - Minimum of 10 years of experience in healthcare financial services, with at least 5 years in a leadership role focused on financial clearance or revenue cycle management.
• Strong knowledge of insurance verification, prior authorizations, and healthcare billing processes.

Skills :

• Excellent analytical and problem-solving skills.
• Strong leadership and team management capabilities.
• Exceptional communication and interpersonal skills.
• Proficiency in healthcare management software and data analysis tools.

Additional Details

Supporting a diverse, equitable and inclusive culture. Emory Healthcare (EHC) is dedicated to providing equal opportunities and access to all individuals regardless of race, color, religion, ethnic or national origin, gender, genetic information, age, disability, sexual orientation, gender identity, gender expression and / or veteran's status.

EHC does not discriminate on the basis of any factor stated above or prohibited under applicable law. EHC respects, values, and celebrates the unique perspectives and backgrounds of all individuals.

EHC aspires to create an environment of collaboration and true belonging for all our patients and team members. Emory Healthcare (EHC) is committed to achieving a diverse workforce through equal opportunity and nondiscrimination policy in all aspects of employment including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training.

ACCOMMODATIONS : EHC will provide reasonable accommodation to qualified individuals with disabilities upon request. To request this document in an alternate format or to request a reasonable accommodation, please contact the Office of Diversity, Equity, and Inclusion.

• PHYSICAL REQUIREMENTS : (Medium-Heavy) 36-75 lbs., 0-33% of the work day (occasionally); 20-35 lbs., 34-66% of the workday;
• frequently); 10-20 lbs., 67-100% of the workday (constantly); Lifting 75 lbs. max; Carrying of objects up to 35 lbs.; Occasional to frequent standing & walking;

Occasional sitting; Close eye work (computers, typing, reading, writing); Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS : Factors affecting environmental conditions may vary depending on the assigned work area and tasks.

• Environmental exposures include, but are not limited to : Blood-borne pathogen exposure; Bio-hazardous waste Chemicals / gases / fumes / vapors;
• Communicable diseases; Electrical shock; Floor Surfaces; Hot / Cold Temperatures; Indoor / Outdoor conditions; Latex; Lighting;
• Patient care / handling injuries; Radiation; Shift work; Travel may be required; Use of personal protective equipment, including respirators;

environmental conditions may vary depending on assigned work area and work tasks.

Financial Benefits

• Competitive Pay
• Retirement planning and counseling
• 403(b) fixed employer-based contribution*
• 403(b) retirement plans with 4% or 5% match based on years of service
• 457(b) plan for eligible employees
• Student loan repayment benefit
• Long-term disability insurance
• Short-term disability insurance
• Life insurance and supplemental life option
• Long-term care insurance option
• Hospital indemnity option
• Auto and home insurance discounts
• Identity protection insurance
• Employee hardship donation program
• Credit Union memberships
• Financial tools, resources and webinars to help with budgeting

Health and Wellness BenefitsMedical and Dental Plans

• Three medical plan options including behavioral and preventive care coverage
• Health Savings Accounts / Flexible Spending Accounts
• Tier Zero Prescription benefits
• Two dental plan options
• Vision plan
• Infertility benefits
• Emory Eye Center and Emory Vision Center discounts
• Emory Aesthetic Center discounts

Wellness Programs

• Employee Assistance Program assistance with relationships, life events, challenges, daily living needs
• Healthy Emory wellness program with incentives
• Discounts at Emory wellness / fitness centers
• Other fitness center discounts
• Diabetes prevention program
• Wellness challenges
• Know Your Numbers kiosks

Childcare Resources

• Discounts
• Placement assistance
• Back-up and emergency care options
• Emory Healthcare childcare co-op / app
• Access to Emory student job network
10 days ago