The Pre-Service Operations Manager is responsible for the daily management and oversight of the organization's pre-service patient access functions, ensuring patients receive timely, accurate, and compassionate service before arriving for care. This position oversees access center operations, pre-service financial clearance, pre-registration, and prior authorization teams, including remote employees.

The Manager is accountable for operational performance, professional development, workflow optimization, regulatory compliance, and collaboration with clinical and revenue cycle departments to support exceptional patient experiences while improving financial outcomes. This role ensures patients are financially and administratively cleared prior to service, reducing delays, denials, and avoidable rework.

This is a full-time salaried position based onsite, with the potential for a hybrid work arrangement based on organizational needs and successful completion of onboarding and performance expectations.

ESSENTIAL FUNCTIONS

Operational Management

1. Manage the daily operations of all assigned pre-service functions.
2. Ensure efficient, patient-centered workflows across scheduling, financial clearance, insurance verification, pre-registration, and prior authorization.
3. Monitor staffing levels and adjust resources to meet patient demand and service expectations.
4. Develop and maintain standardized procedures to promote consistency across all teams.
5. Identify opportunities to improve operational efficiency and implement process improvements.
6. Participate in strategic planning and departmental initiatives to enhance patient access and revenue cycle performance.

Scheduling and Access Center Operations

1. Oversee access center professionals responsible for:

• Multi-specialty scheduling
• Provider template utilization
• Call quality monitoring
• Patient communications
• Switchboard/Operator functions
• Service recovery
• Work queue management

2. Monitor key access center metrics, including:

• Average speed of answer
• Call abandonment rate
• Hold times
• First-call resolution
• Scheduling accuracy
• Productivity standards

Pre-Service Financial Clearance

1. Manage financial access specialists responsible for:

• Financial clearance
• Insurance education
• Patient cost estimates
• Financial Assistance screening
• Medicaid screening
• Payment plan discussions
• Point-of-service collections

2. Ensure patients receive accurate financial information prior to receiving services.

Referrals & Authorization

1. Manage prior authorization specialists responsible for:

• Obtaining required payer authorizations
• Tracking authorization status
• Coordinating with providers and clinical staff
• Escalating authorization delays
• Monitoring payer requirements
• Performing medical necessity review
• Reducing authorization-related denials
• Work queue management

Pre-Registration and Insurance Verification

1. Oversee Pre-Registration professionals responsible for:

• Insurance eligibility verification
• Demographic validation
• Registration accuracy
• Required documentation
• Work queue management

2. Promote complete and accurate patient records prior to service.

Leadership Responsibilities

1. Recruit, hire, train, coach, and develop professionals.
2. Conduct performance evaluations and regular coaching sessions.
3. Establish productivity and quality expectations.
4. Monitor professional performance using key performance indicators.
5. Promote professional engagement and development.
6. Support succession planning and cross-training initiatives.

General

1. Participate in continuing education opportunities.
2. Maintains professional growth and development through seminars, workshops and professional affiliations to keep abreast of latest trends in the field of expertise.
3. Ensures no injuries to self or others by following safe work practices and policies. This includes, but is not limited to: security and safety, understanding of chemical Safety Data Sheets (SDS), equipment, infection control, fire, disaster, safe lifting and body mechanics.
4. Ensures self-compliance with organization policies and procedures, as well as labor agreements.
5. Ensures the interface with team members and other support groups is conducted in a courteous and efficient manner conducive to the organization's values.
6. Conducts self in a professional manner and ensures personal appearance meets the standards necessary to perform the job function while representing the organization.
7. Ensures that additional accountabilities, as may be required by management, be handled in a manner necessary to meet organizational standards.

WORK ENVIRONMENT

The professional in this position reports to the Director of Revenue Cycle. Professionals in this position will work closely with patients and other Samaritan professionals within various departments including Registration, Clinical departments, Patient Financial Services, Coding, Care Management, Physician offices, Information Technology, and others.

EDUCATION & EXPERIENCE

Education:

1. Bachelor's degree in Healthcare Administration, Business Administration, Health Information Management, Finance, or a related field required.
2. Basic Life Support Heartsaver (HS) level to be completed within three (3) months of hire.

Experience:

1. Minimum of five (5) years of progressively responsible experience in healthcare patient access, revenue cycle, or related operations.
2. Minimum of two (2) years of supervisory or management experience.
3. Experience managing multiple functional areas preferred.
4. Experience managing call center or centralized scheduling areas preferred.
5. Experience leading remote or hybrid teams preferred.
6. Experience with Epic or similar electronic health record system preferred.

Skills/Competencies:

1. Patient Access operations
2. Revenue Cycle principles
3. Insurance verification and eligibility
4. Prior authorization processes
5. Financial counseling
6. Scheduling and registration workflows
7. Call Center operations
8. Medicare, Medicaid, and commercial insurance regulations
9. Process improvement methodologies
10. Leadership and staff development
11. Conflict resolution and change management
12. Excellent communication and interpersonal skills
13. Strong organizational and problem-solving abilities
14. Proficiency with Microsoft Office applications
15. Demonstrates competency in ability to care for customers/patients across the age continuum.
16. Ability to maintain confidentiality and comply with HIPAA requirements.
17. Ability to learn and apply organizational policies, procedures, and communication protocols.
18. Ability to work independently and as part of a team.
19. Demonstrates competency on equipment listed on department specific checklist.
20. Strong critical thinking skills: seeks resources for direction when necessary. Performs independent problem solving. Decision-making is logical and deliberate.
21. Performs actions that demonstrate accountability. Exercises safe judgment in decision-making. Practices within legal and ethical guidelines.

PHYSICAL REQUIREMENTS

1. Occasional standing, walking, lifting, reaching, kneeling, bending, stooping, pushing and pulling. Light physical effort, ability to lift/carry up to 25 lbs.
2. Mostly sedentary work. Prolonged periods of sitting.
3. Frequent computer, telephone, and video conferencing use.
4. Good reading eyesight; color vision - ability to distinguish and identify different colors.
5. Ability to communicate using verbal and/or written skills for accurate exchange of information with physicians, nurses, health care professionals, patients and/or family, and the public.
6. May require occasional travel between hospital and clinic locations.
7. May require occasional after-hours support to address operational needs.

As a Samaritan professional, you will be asked to commit to being part of a culture grounded in our Mission, Vision, Values, and Strategy that brings service and operational excellence to life each day while creating an exceptional experience for our patients, professionals, physicians, and students. Additionally, how we present ourselves matters, and adherence to our Professional Appearance Policy reflects the pride, respect, and professionalism we bring to those we serve.