Mgr, Financial Clearance - (Business Center) - Full-time Days
Serving the community since 1961, WakeMed Health & Hospitals is a nationally recognized, private, not-for-profit health care organization founded and based in Raleigh, N.C. The largest health system in Wake County, WakeMed exists to improve the health and well-being of our community by providing outstanding, compassionate, patient- and family-centered care to all. The 919-bed system comprises a network of facilities throughout the Triangle area, delivering health and wellness services that bring added value to the communities we serve. WakeMed is a leader in cardiac and vascular care, women’s and children’s services, emergency medicine and trauma care, physical rehabilitation, orthopaedics and neurosciences. Specialty facilities include the WakeMed Heart Center, Children’s Hospital, Women’s Pavilion and Birthplace, Rehabilitation Hospital, Adult and Children’s Emergency Departments and a Level 1 Trauma Center. WakeMed’s team of more than 9,400 employees, 2,000 volunteers, 1,300 affiliated physicians, and the more than 300 physicians employed by WakeMed Physician Practices use the most advanced technologies along with the best minds and the biggest hearts to ensure the finest quality in health care and community health. For more information, visit www.wakemed.org.
As an Equal Opportunity Employer, WakeMed provides an inclusive work environment that
promotes the valuing of differences, respect for people and cooperativeness among our diverse
workforce. WakeMed does not discriminate against any employee or applicant in any terms or
conditions of employment. All applicants/employees are considered for employment, transfer,
promotion or training without regard to race, religion, color, gender, gender identity/expression,
genetics, sexual orientation, age, pregnancy, national origin, disability or veteran status.
The Manager of Financial Clearance is responsible for planning and directing all financial clearance services for the following functions: prior authorizations and referral, pre-registration, pre-service collections and preadmissions,. The Financial Clearance Manager ensures the review and interpretation of denial reports, productivity reports, quality and all other reports as necessary. This position has overall high level responsibility for resolution of problems related to financial clearance as well as personnel activities including hiring, training, development, and termination of assigned staff. Ensures the Financial Clearance department is appropriately staffed and employees trained. Develops and enforces policies, procedures and operational guidelines to maximize financial reimbursement. Reports to the Director of Patient Access while serving as a liaison with the community, physician offices, and payers related to Financial Clearance issues. Acts as an advocate for the patient, physician, and hospital relative to compliance with federal, state, and third party regulatory requirements. Demonstrates a high level of integrity and innovative thinking, and actively contributes to the success of the organization.
7 Years Related Position Experience Required - And 2 Years Management Required
Bachelor's Degree Required - And Master's Degree Preferred
: Monday - Friday, 8:00am - 6:00pm
: As Needed
: As Needed
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