Senior Manager of Pre-Registration and Financial Clearance

LOCATION: JOHN H STROGER, JR. HOSPITAL OF COOK COUNTY

DEPARTMENT: PATIENT ACCESS

SHIFT: 8:00 AM- 4:00 PM

This position is exempt from Career Service under the CCH Personnel Rules.

JOB SUMMARY NON-UNION

The Senior Manager of Pre-Registration and Financial Clearance (Senior Manager) is responsible for managing and overseeing processes in the pre-registration and patient financial clearance department across Cook County Health (CCH). This position will ensure optimal use of all resources to achieve departmental goals for productivity and other performance indicators for applicable financial results determining workflow priorities and effective methodologies to complete tasks. The Senior Manager will impact denials from third party payers through complete and accurate demographic, insurance verification update and financial clearance.

TYPICAL DUTIES

* Directs, leads, and manages the Pre-registration and Financial Clearance Department functions to ensure they are performed efficiently throughout the revenue cycle enterprise, which includes maintaining an adequately trained staff to handle all patients in outpatient clinic settings and same day surgeries. Financial Clearance functions include but are not limited to, insurance and benefit verification, regulatory requirements, health plan requirements, and insurance verification. Pre-Registration functions include verification in a manner that ensure patients are processed appropriately according to the most current policies and procedures/

* Oversees the referral process to Financial Counseling to identify conversion opportunity for uninsured or under-insured population.

* Ensures proper financial communication during pre-registration process that includes creating a patient liability estimate and collection of patient liability.

* Provides appropriate training, guidance, continuing education, and overall job competencies of direct reports.

* Establishes, maintains, and manages productivity and quality standards. Maintains, develops, and implements operating policies and procedures pertinent to areas of responsibility.

* Remains informed of all government, managed care/commercial and industry trends that impact revenue cycle operations Assists department director with assessments of internal controls, policies, and procedures to ensure compliance with appropriate federal, state, and regulatory entity guidelines and procedures.

* Utilizes departmental protocol and methodologies to monitors quality by performing audits of outputs and ensuring all associated processes are followed consistently.

* Manages ongoing analysis, development, quality improvement and implementation of methods and systems to improve efficiency and effectiveness of pre-service financial clearance functions to the organization.

* Serves as a project manager/change management leader and supports as requested.

* Communicates effectively and in cooperation with management/departments within CCH and with outside agencies.

* Provides weekly key performance indicators (KPI) outcomes reports to Revenue Cycle leadership on status of processes and pre-service functions and responsibilities.

* Participates in leadership meetings and projects to advocate positions that will help the Department and is in the best interest of the organization.

* Troubleshoots current and anticipate potential problems and resolve them by involving appropriate departments and personnel when needed and have the expertise to know when to involve others.

* Uses denials data to proactively re-engineer processes to avoid insurance eligibility denials.

* Performs other duties as assigned.

MINIMUM QUALIFICATIONS

• Bachelor's degree of higher from accredited college or university.
• A minimum of five (5) years of pre-registration experience in a health care setting with three (3) years of experience managing staff is required.
• A minimum of two (2) years of experience and proficiency utilizing pre-registration systems, i.e., premier eligibility and OneSource is required.

PREFERRED QUALIFICATIONS

• Bachelor's degree or higher in Business Administration, Organizational Development, Finance, Accounting, or Health Care Administration from an accredited college or university is preferred.
• A minimum of five (5) years of management experience in healthcare revenue cycle operations for a large, complex health care environment, including experience in an academic medical center is preferred.

KNOWLEDGE, SKILLS, ABILITIES AND OTHER CHARACTERISTICS

• Knowledge of Medicare and third-party payer reimbursement
• Extensive knowledge in managed care requirements as they relate to hospital reimbursement
• Excellent interpersonal, verbal and written communication skills necessary to communicate with all levels of staff and a patient population composed of diverse cultures and age groups
• Excellent organizational skills
• Detail oriented, with a data driven attitude
• Strong decision making and self-motivation skills
• Ability to work in a team environment and to collaborate with a variety of professionals.
• Ability to maintain and convey a positive attitude and customer service approach to program development
• Ability to multitask and problem solve

BENEFITS PACKAGE

• Medical, Dental, and Vision Coverage
• Basic Term Life Insurance
• Pension Plan
• Deferred Compensation Program
• Paid Holidays, Vacation, and Sick Time
• You may also qualify for the Public Service Loan Forgiveness Program (PSLF)

For further information on our excellent benefits package, please click on the following link: http://www.cookcountyrisk.com/

VETERAN PREFERENCE
PLEASE READ

When applying for employment with the Cook County Health & Hospitals System, preference is given to honorably discharged Veterans who have served in the Armed Forces of the United States for not less than 6 months of continuous service

To take advantage of this preference a Veteran must:

* Meet the minimum qualifications for the position.
* Identify self as a Veteran on the employment application by answering yes to the question by answering yes to the question, "Are you a Military Veteran?"
* Attach a copy of their DD 214, DD 215 or NGB 22 (Notice of Separation at time of application filing. Please note: If you have multiple DD214s, 215s, or NGB 22S, please submit the one with the latest date. Coast Guard must submit a certified copy of the military separation from either the Department of Transportation (Before 9/11) or the Department of Homeland Security (After 9/11). Discharge papers must list and Honorable Discharge Status. Discharge papers not listing an Honorable Discharge Status are not acceptable

OR
* A copy of a valid State ID Card or Driver's License which identifies the holder of the ID as a Veteran, may also be attached to the application at time of filing.

If items are not attached, you will not be eligible for Veteran Preference

VETERANS MUST PROVIDE ORIGINAL APPLICABLE DISCHARGE PAPERS OR APPLICABLE STATE ID CARD OR DRIVER'S LICENSE AT TIME OF INTERVIEW.

MUST MEET ALL REQUIRED QUALIFICATIONS AT TIME OF APPLICATION FILING.

*Degrees awarded outside of the United States with the exception of those awarded in one of the United States' territories and Canada must be credentialed by an approved U. S. credential evaluation service belonging to the National Association of Credential Evaluation Services (NACES) or the Association of International Credential Evaluators (AICE). Original credentialing documents bust be presented at time of interview.

*Please note all offers of Employment are contingent upon the following conditions: satisfactory professional & employment references, healthcare and criminal background checks, appropriate licensure/certifications and the successful completion of a physical and pre-employment drug screen.

*CCHHS is strictly prohibited from conditioning, basing or knowingly prejudicing or affecting any term or aspect of County employment or hiring upon or because of any political reason or factor.

COOK COUNTY HEALTH & HOSPITALS SYSTEM IS AN EQUAL OPPORTUNITY EMPLOYER