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Central Authorization Manager - Troy
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Job Description

GENERAL SUMMARY: 

As a member of the hospital revenue cycle team, manages, coordinates or participates in a wide variety of operational and personnel functions related to the central authorization department. Has a comprehensive knowledge of a wide range of processes and systems related to revenue cycle, patient access and registration. Plans and directs day-to-day operations. Assists in leading the development and implementation of improvement processes as well as metrics to measure performance. Participates in quality assessment & continuous quality improvement activities. Performs other responsibilities to ensure an efficient and customer-focused operation. 

PRINCIPAL DUTIES AND RESPONSIBILITIES: 
  • Manage day-to-day administrative & operational functions of the central authorization department through the supervision of multidisciplinary staff.
  • Coordinates with key revenue cycle departments including ATMO, DEM, Clinics and OR to assure successful business processes fit and perform within required clinical needs resulting in appropriate reimbursement for the Hospital and System
  • Manages complex projects that include participating with multi-disciplinary process improvement teams from across the System
  • Manage the successful procurement of and pre-procedure verification of insurance authorizations for those services ordered and performed by staff physicians and hospital resources, 
  • Manage the successful securing of insurance authorizations required for community physicians to perform services in our facilities.
  • Assist department Director in developing and implementing the departmental budget. Recommend the acquisition of equipment, renovations and staff. Ensure adherence to budgetary guidelines. 
  • Communicate patient pay responsibilities and collect patient pre-payment as needed.
  • Manage authorization related claim rejections to ensure optimal revenue recovery. Track and monitor rejection trends for the purpose of implementing prevention improvements.
  • Interview, hires, schedules, assigns work to, evaluates, disciplines &, when necessary, recommends discharge of departmental personnel. Completes timely performance appraisals. Ensures compliance with departmental and organizational policies & procedures. 
  • Assist the department leadership with overseeing all quality assessment and continuous improvement activities.
  • Designs, implements & conducts educational programs for staff regarding changes and updates to third party requirements impacting the revenue cycle and insurance authorization requirements.
  • Develop and implement departmental policies and procedures to achieve revenue cycle objectives.
  • Analyze data to identify patterns and trends of performance. Addresses process performance issues and implements improvement plans. 
  • Track, trend and monitor information to determine strategies needed to meet weekly/monthly departmental goals.

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Job Requirements

EDUCATION/EXPERIENCE REQUIRED: 
  • Bachelor’s degree. 
  • Prior supervisory experience in a revenue cycle, clinic or hospital setting. 
  • Three to five (3-5) years of revenue cycle experience preferred, including but not limited to billing, registration, insurance verification, point of service collection related. 
  • Comprehensive knowledge of a wide range of revenue cycle processes, insurance contracts, and billing is preferred. 
  • Experience with clinical operations is preferred. 
  • Proficient knowledge of Word, Excel, Epic and the Internet. Ability to create, analyze and interpret reports and spread sheets. 
  • Must have the ability to independently organize and prioritize responsibilities; problem solve and implement solution based ideas. 
  • Ability to effectively work and adapt to a wide variety of different staffs, environments and situations. 
  • Ability to interact with leadership, staff, clinicians, patients and visitors of various social- economic backgrounds. 
  • Coach and mentor staff in a positive manner. 
  • Must have excellent written & verbal communication skills & strong facilitative interpersonal skills.

Job Snapshot

Employment Type Full-Time
Job Type Admin - Clerical
Education Not Specified
Experience Not Specified
Manages Others Not Specified
Industry Healthcare - Health Services
Required Travel None
Job ID 172013
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Central Authorization Manager - Troy


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