Job SummaryResponsible for overseeing the financial clearance operations to ensure patient eligibility, benefits verification, and authorization processes are accurately managed. Ensures efficient and compliant financial clearance workflows that support revenue cycle goals and improve the patient experience.
Essential Functions:
- Leads financial clearance operations, including eligibility verification, benefits coordination, and prior authorization processes.
- Collaborates with patient access, billing, and managed care teams to optimize workflows and reduce delays.
- Develops and implements policies to ensure compliance with regulatory requirements and payer guidelines.
- Monitors financial clearance performance metrics, identifying and addressing areas for improvement.
- Manages relationships with payers and other stakeholders to resolve issues related to coverage and authorizations.
- Oversees the training and development of financial clearance staff, fostering a knowledgeable and service-oriented team.
- Analyzes trends in denials and authorizations, developing strategies to minimize financial risk.
- Prepares reports for senior leadership on financial clearance activities and performance.
- Ensures the accuracy and efficiency of data collection and documentation for patient financial records.
QualificationsEducation- Bachelor's Degree in Healthcare Administration, Business, Finance or related field of study required
- Master's Degree in a related field of study preferred
Experience- 8+ years of experience required in financial clearance, revenue cycle management, contract management, or other closely related role, preferably in a managed care setting
- 5+ years of experience in a management or leadership role required
Knowledge, Skills and Abilities- Strong understanding of payer regulations, authorizations, and managed care requirements.
- Proficiency in healthcare revenue cycle processes and systems.
- Analytical skills to assess financial data and operational metrics.
- Effective communication and collaboration skills to work with cross-functional teams and external partners.
- Leadership abilities for team management and staff development.
Additional Job Details (if applicable)Remote TypeRemote
Work Location399 Revolution Drive
Scheduled Weekly Hours40
Employee TypeRegular
Work ShiftDay (United States of America)
Pay Range$124,342.40 - $180,897.60/Annual
Grade9
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
