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DIRECTOR FINANCIAL CLEARANCE OPERATIONS

YONKERS, NY, US


The Director of Financial Clearance Operations is responsible for administering, coordinating, and reviewing the performance of financial clearance functions, including insurance verification, obtaining insurance referrals and prior authorizations for elective procedures, outpatient imaging and office-based procedures and for the notification of emergency admissions. This position oversees the Pre-Service Unit, and is responsible for ensuring hiring and training practices are appropriate and effective. The leader seeks to identify and implement new and emerging strategies to increase efficiency, improve processes, and enhance the patient and physician experience. As part of achieving these goals, the Director of Financial Clearance Operations identifies opportunities to work with leaders in other areas – including clinical services, the Hospital and Professional business offices, contract management, and denials management – to increase care coordination, ensure payers are prepared to reimburse the organization for services rendered in a timely manner, and improve communication and process efficiency between departments and entities.  The Director is responsible for  centralizing the referral and authorization process across the medical center. The Director is responsible for the review and implementation of vendor services and ensure product testing is accurate before deployment to production in EPIC. As part of the centralization of the referral and authorization functions the Director will work with each areas to evaluate the FTE needs, current process flow and create new work-flows. Will be lead coordinator for the transition of the staff with the department, union and labor. Will create and maintain metrics to report to the departments and senior leadership on the denial status for pre and post centralization of each unit. 

 

 

Education/Skills:

 

Bachelor's Degree

 At least 7-10 years of experience in a clinical (hospital/surgical/outpatient clinic) or revenue cycle setting 
• At least 5-7 years of management experience in a health care setting is required
• Advanced knowledge of financial clearance, insurance verification, and prior authorization, payer reimbursement processes, and insurance and medical terminology 
• Strong leadership skills 
• Detail-oriented and organized, with strong problem-solving abilities 
• Demonstrate ability to manage and mentor a team 
• Exceptional interpersonal abilities, including strong written and verbal communication skills
• Proven ability to manage multiple projects simultaneously while achieving positive outcomes
• Strong data analysis skills 
• Experience with Epic, Microsoft Word, Office, and Excel 
 

 

Department: Patient Access Center Bargaining Unit: Non Union Campus: YONKERS  Employment Status: Regular Full-Time Address: 3 Executive Boulevard, Yonkers
Shift: Day Scheduled Hours: 9 AM-5:30 PM Req ID: 176106 

 

Montefiore is an equal employment opportunity employer. Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law. 

 

N/A; #GDMD 


Mission:
To heal, to teach, to discover and to advance the health of the communities we serve.

Vision:
To be a premier academic medical center that transforms health and enriches lives.

Values
Define our philosophy of care, they shape our actions and motivate and inspire us to pursue excellence and achieve the goals we have set forth for the future. Our values include:

  • Humanity
  • Innovation
  • Teamwork
  • Diversity
  • Equity

 

 

 


Nearest Major Market: Yonkers
Nearest Secondary Market: New York City