Type: Full-Time (75 hours biweekly)
Shift: Days
Hours: Varies
Pay: $135,000 -$145,000
Job Summary:The Director, Patient Access & Financial Clearance provides strategic and operational leadership for front-end Revenue Cycle functions across Episcopal Health Services. The role is responsible for building a consistent, measurable, and sustainable operating model for Patient Access and Financial Clearance, with accountability for registration, pre-registration, eligibility and benefits verification, authorization governance, financial clearance, patient estimates and financial communication, point-of-service collections, registration quality, front-end denial prevention, performance management, and workflow standardization. This is a transformation-focused leadership role requiring the ability to build and standardize front-end Revenue Cycle capabilities in an environment where workflows, ownership, controls, and performance infrastructure are continuing to mature. The Director partners across clinical, operational, financial, and technology teams to improve the patient experience, protect revenue, strengthen accountability, and prepare the organization for MEDITECH Expanse.
Responsibilities:- Operational:
- Provides strategic and operational leadership for Patient Access and Financial Clearance functions, including registration, pre-registration, eligibility and benefits verification, authorization governance, patient estimates, point-of-service collections, registration quality, and related front-end Revenue Cycle workflows.
- Builds and standardizes workflows, roles, controls, escalation paths, and performance expectations across Patient Access and Financial Clearance operations.
- Leads, coaches, and develops managers, supervisors, and staff while establishing clear accountability for performance, professionalism, service, and results.
- Establishes and oversees a consistent Financial Clearance operating model supporting timely eligibility and benefits verification, authorization, referral requirements, and pre-service financial review.
- Serves as the Revenue Cycle governance owner for authorization standards across the enterprise, including payer requirements, work queues, turnaround expectations, documentation standards, escalation pathways, performance monitoring, and denial feedback, including where authorization work remains operationally decentralized.
- Establishes standards for patient estimates, financial communication, point-of-service collections, and appropriate handoffs to the team responsible for Financial Assistance and Charity Care.
- Establishes registration quality standards, audit processes, and corrective action mechanisms and uses downstream denial and billing outcomes to improve front-end workflows, training, and accountability.
- Develops and monitors key performance indicators, including registration accuracy, eligibility completion, authorization performance, financial clearance timeliness, point-of-service collections, productivity, and front-end denial trends.
- Uses operational and financial data to identify trends, prioritize improvement opportunities, and hold leaders accountable for measurable results.
- Serves as the Revenue Cycle business owner for applicable Patient Access and Financial Clearance workflow design and optimization associated with MEDITECH Expanse, including current-state assessment, requirements, testing, validation, adoption, and operational readiness.
- Partners with IT, Revenue Cycle Systems, clinical, nursing, physician, ambulatory, Finance, Patient Experience, Managed Care, HIM, Revenue Integrity, and Patient Financial Services leaders to resolve front-end barriers and strengthen cross-functional workflows.
- Establishes clear Revenue Cycle standards and governance without assuming operational ownership of functions that appropriately remain within clinical or other departments, and escalates material operational, financial, compliance, or patient-experience risks with clear recommendations.
- Supervisory:
- Oversees day-to-day Patient Access and Financial Clearance operations within the Director's assigned scope and ensures appropriate coverage, productivity, service, and performance.
- Leads, mentors, and develops Patient Access leaders and staff; establishes clear expectations, delegates appropriately, and holds the management team accountable for results.
- Assesses staffing, workload, productivity, and resource needs and makes recommendations based on operational requirements and performance.
- Reviews performance reports, denial trends, quality findings, and operational risks and ensures corrective actions are assigned, monitored, and completed.
- Develops and maintains departmental policies, standard work, training expectations, and operating practices that support a consistent front-end Revenue Cycle model.
- Leads change associated with workflow redesign, technology implementation, and organizational transformation while maintaining effective day-to-day operations.
Requirements:- Bachelor's degree in Healthcare Administration, Business Administration, Health Information Management, Public Health, or a related field
- Master's degree (MBA, MHA, MPH, or related) preferred
- Minimum 7 years of progressive healthcare Revenue Cycle or Patient Access experience, with significant hospital Patient Access/front-end Revenue Cycle experience
- Minimum 5 years of progressive leadership experience, including responsibility for managers, supervisors, or complex multifunctional teams
- Demonstrated experience building, redesigning, or significantly transforming Patient Access or Financial Clearance operations
- Hospital Revenue Cycle experience required; hospital and ambulatory experience preferred
- CHAM, CRCR, or another relevant Revenue Cycle certification preferred
- Strong knowledge of hospital Patient Access and front-end Revenue Cycle operations
- Strong understanding of registration, eligibility and benefits verification, authorization, financial clearance, patient estimates, point-of-service collections, and front-end denial prevention
- Demonstrated ability to build workflows, performance standards, accountability structures, and operational controls
- Ability to use data and performance metrics to drive measurable improvement
- Strong leadership, coaching, decision-making, and change-management skills
- Ability to lead across organizational boundaries and influence stakeholders without direct reporting authority
- Experience with major workflow redesign, EHR implementation, or Revenue Cycle technology optimization strongly preferred
- MEDITECH and/or MEDITECH Expanse experience preferred
