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Description

Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:

The Pre-Service Manager will be responsible for managing the overall operations of the Pre-Service area. Pre-Service operations may include, but are not limited to pre-registration, insurance verification, scheduling, patient estimates, price transparency, and pre-authorization. Provides the necessary leadership to achieve the objectives of the Patient Financial Services Department and the hospital are met. Must plan, develop, and manage efficient and effective standard processes for all the modalities of Pre-Service. Services provided must meet the medical, administrative, legal, ethical, regulatory, and institutional requirements utilized in the health care delivery system at UNC Health Wayne. The Manager is familiar with and has general knowledge of managed care, Medicare and Medicaid rules regarding, billing rules, coverage issues and reimbursement.

Responsibilities:

1. Oversees the operation of the Pre-Service teams (Scheduling, Authorizations, Pre-registration, and Estimates).

2. Keeps up to date on changes to payor requirements and proactively communicate changes to team.

3. Reviews metrics to identify trends and root causes. Initiates or guides supervisor to initiate action to mitigate the root cause as needed.

4. Rounds with teammates.

5. Holds team meetings and huddles with scheduling, pre-authorizations, and pre-registration teammates.

6. Coordinates with Pre-authorization and Scheduling leads to ensure specialists are meeting expectations.

7. Ensures all teammates have the tools and training needed to perform their job duties.

8. Maintains quality control audits and compiles statistical data in various categories, such as number of incoming calls, phone wait times, quality audits and productivity.

9. Ensures the accurate and timely completion of patient scheduling, insurance verification, authorizations, estimates and pre-registration duties to ensure that patient accounts are accurate.

10. Handles account escalations and troubleshoots issues related to any pre-service modality.

11. Participates in Revenue Cycle and organizational initiatives as directed by Director of Patient Financial Services.

12. Collaborates with other department leaders to address interdepartmental issues and opportunity areas.

13. Establishes communication structure to keep team informed on organizational updates and changes.

14. Adheres to HIPAA and confidentiality regulations and policies.

15. Promotes team morale.

16. Keeps Director updated of any concerns, issues or problems and progress towards goals.

17. Manages staffing for Pre-service area (Scheduling, Pre-authorizations, and Pre-registration).

18. Interviews and hires candidates, evaluates and coach’s individual teammates, and issues discipline/corrective action to teammates in collaboration with Human Resources and Revenue Cycle Director, when required.

19. Completes 30, 60 and 90 day and annual performance reviews for the areas managed. Ensures provisions are made to correct deficiencies.

20. Always presents and promotes a professional demeanor, establishes high standards of customer service, supports responsibility, pride, and teamwork, remains calm under pressure, and offers reasonable solutions for problems.

Other information:

Education

• High school graduate/equivalent or higher degree required.

• Associate or bachelor’s Degree preferred.

Licensure/Certification

• CRCR certification within one year of employment.

• CHAA or CHAM certification preferred.

Experience

• Three (3) years’ supervisory or management experience in a hospital/healthcare environment is required.

Job Details

Legal Employer: Wayne Health

Entity: Wayne UNC Health Care

Organization Unit: Patient Accounts

Work Type: Full Time

Standard Hours Per Week: 40.00

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: WAYNE MED

Exempt From Overtime: Exempt: Yes

Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.