Manager - Pre-Authorizatoin

The Manager of Pre-Authorization is responsible for planning, developing, organizing, and managing the Pre-Authorizatoin department and is responsible for performance and effectiveness of these department(s). The Manager will be responsible for the coaching and development of all staff performing these functions and implementing short and long-term plans and objectives to improve customer service and collect quality information. As a subject matter expert, this person must provide leadership and contribute to the revenue cycle and organizational goals and is responsible for meeting the mission and goals of Ensemble, as well as meeting regulatory compliance requirements. The Manager of Pre-Access will work closely with the Director of Pre-Access to align processes and procedures with Ensemble Health Partners policies at an assigned client.

Manager is responsible for directly managing the operations for the scheduling, pre-registration, verification, or authorization departments. Departments are responsible for scheduling, pre-registering, completing medical necessity / compliance checks, providing proper patient instructions, collecting insurance information, receiving and processing physician orders, submitting or validation authorization and providing excellent customer service.

Develops and manages departmental staffing needs. Prepares monthly reports as requested.

Establishes departmental goals with associates to optimize performance and meet organizational while improving operations to increase customer satisfaction and meet financial goals of the organization.

Coordinates associate work schedules to provide adequate daily staffing coverage.

Collects, interprets and communicates performance data using various tools and systems, while also using this data to make decisions on how to achieve performance goals.

Works with internal and external customers to make key decisions, impacting either the whole organization or an individual patient. Works closely with ancillary departments to establish and maintain positive relations to ensure revenue cycle goals are achieved.

Performs other duties as assigned.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Associates may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation.

Bachelor's degree in any discipline.

10+ years of experience in US Healthcare operations with 5+ years of experience in Revenue Cycle Management.

Experience in Patient Access, Billing/charge and Payment posting will be added advantage.

Knowledge of Medicare, Medicaid & ICD & CPT codes used on Denials.

Strong people management skills, ability to motivate teams, resolve conflicts, and drive engagement.

Excellent communication Skills (both written & verbal).

Preferred Certified Revenue Cycle Representative (CRCR).