Director, Financial Clearance

Overview

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

Benefits

• 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

• 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.
• 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.
• 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.
• 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.
• 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.
• 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 : Bachelor's degree in Healthcare Administration, Finance, Business Administration, or a related field; Master's 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.

ACCOMMODATIONS : EHC will provide reasonable accommodation to qualified individuals with disabilities upon request.

• 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.

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