Manager, Pre-Access Services

Summary

Oversee operations of scheduling, insurance verification, authorization/referrals, and financial clearance departments.

Essential Duties and Responsibilities

These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned.

• Provides day-to-day operational leadership for Pre-Access Services, including staffing, performance management, and employee relations.

• Oversees hiring, onboarding, training, evaluations, and disciplinary processes.

• Serves as a liaison between patients, families, providers, and internal teams to ensure coordination of care.

• Ensures compliance and quality control standards are consistently met across all functions.

• Acts as a subject matter expert (SME) on diagnostic procedures, workflows, and patient access processes.

• Leads and supports scheduling operations for multiple tests and procedures to maximize efficiency.

• Partners with clinical teams to optimize schedules, resource utilization, and revenue outcomes.

• Maintains and updates scheduling templates, protocols, and workflow instructions.

• Serves as an SME on insurance, including coverage, authorizations, and payer requirements.

• Applies knowledge of ICD coding, medical necessity, and patient financial communication (e.g., ABNs).

• Monitors industry trends and payer changes to ensure ongoing compliance and best practices.

• Utilizes reporting and dashboards to drive performance, productivity, and 96% accuracy standards.

• Leads customer service and service recovery efforts to enhance patient experience.

• Provides hands-on support, staff mentoring, cross-coverage, and technical guidance as needed.

• Drives employee engagement and retention while maintaining a consistently professional presence and communication style.

Supervisory Responsibilities

Reports to: Pre-Access Services

Supervises: Schedulers, Financial Services Rep, Verifiers, Pre-Registration, Authorization Coordinators

Responsibilities:
Responsible for the daily operations, quality, and service of the Pre-Access Services department, including but not limited to Central Scheduling, Pre-Registration, Insurance Verification, Authorization/Referral Management, and Financial Clearance for hospital-based services. This role includes oversight of the high-volume Patient Access Contact Center that services patients seeking care with various entities using multiple scheduling/registration/billing platforms. This role also includes all aspects of financial clearance (estimates, insurance verification, auth/referral, pre-service payments, financial assistance, etc.). Ensures the department exemplifies service excellence, professionalism, and responsiveness to both internal and external customers. Provides leadership and administers human resource policies and practices in a multi-skilled, multi-functional environment.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and Experience

• Minimum Required Education: Bachelor’s Degree; Four (4) years of management experience will be considered in lieu of degree.

• Preferred Education: Master’s degree

• Experience: 5 years of experience within a healthcare revenue cycle setting required. One year experience with Epic EMR is required.

Certificates, Licenses, Registrations

Professional certification required within one (1) year of hire; Certified Healthcare Access Manager (CHAM), Certified Revenue Cycle Representative (CRCR), or Prior Authorization Certified Specialist (PACS) certification preferred.