Financial Verification Manager

The vision of Clinical Health Network for Transformation (CHN) is to support the mission and promise of Planned Parenthood to bring high-quality, affordable care to every member of our communities. CHN is a collaboration between Planned Parenthood affiliates across the United States. CHN is looking for individuals who are committed to supporting our shared goal of strengthening and enhancing our awareness and commitment to advancing the cause of health equity in our organization. Reporting to the Director Patient Access, the Financial Verification Manager for Clinical Health Network for Transformation (CHN) is responsible for the oversight of the financial verification process. Supervises the team who performs financial clearance and insurance inquiry services for the following functions: preauthorization procurement, proactive financial coverage screening, complex insurance questions & benefits verification, and complex self-pay estimates. The Financial Verification Manager ensures the review and interpretation of denial reports, manual insurance verification reports, authorization review and procurement worklists, and all other reports, as necessary. This position has an overall high-level responsibility for resolution of problems related to financial clearance as well as personnel activities including hiring, training, and development of assigned staff. The Financial Verification Manager will act as a single point of contact for initial communication with interdependent functions within Revenue Cycle and Patient Access. As such, they are responsible for facilitating bidirectional communication between frontline staff, Revenue Cycle, Patient Access Center, and leadership. Essential Functions • Supervises a Financial Verification Supervisor and a team of Financial Verification Specialists to ensure all administrative and technical functions of financial verification are being handled efficiently and effectively • Maintain competence to resolve direct consumer interactions; some interactions may include the following: determine eligibility for services, provide price estimates and/or guarantees for scheduled services, create and maintain payment plans, field inquiries about statements and Explanations of Benefits (EOB), provide financial assistance, address patient complaints • Ensure the financial verification team is appropriately staffed with trained employees • Serve as a liaison with the patients, providers, and payers related to financial verification issues • Act as an advocate for the patient, provider, and CHN relative to compliance with federal, state, and third-party regulatory requirements • Demonstrate an elevated level of integrity and innovative thinking and actively contribute to the success of the organization • Participate in the development and implementation of CHN s improvement and operations initiatives • Measure and coach on departmental productivity, performance, and improvement opportunities • Hire, direct, coach, and check the performance of all direct reports, to develop and support a high-performance team that meets organizational and department goals • Problem-solve escalated concerns from CHN member affiliate health centers and/or patients • Drive innovation with our front-end method and processes to lower operational costs and improve AR (Accounts Receivable), transaction times, screening rates, and approval rates with our affiliate partners • Work with CHN leadership in development of short- and long-term business and strategic plans and organizational structure within the Patient Access center • Execute efforts to drive financial clearance activities toward data driven operations • Work and build trust across cultural differences • Creates and promotes a culture of continuous improvement • Ensures compliance with all CHN and affiliate policies, as well as all state and federal regulations • Demonstrates a commitment to CHN and Planned Parenthood s mission related to health equity, especially centering racial equity, and deep sense of accountability to community • Demonstrates a commitment to learning about and enhancing practices related to racial equity and the impact of structural racism on healthcare systems • Supplies positive and development feedback and accountability related to practices including, but not limited to, equity The above duties and responsibilities are not an exhaustive list of required responsibilities, duties, and skills. Other duties may be added, and this job description can be amended at any time. Qualifications and Experience (Required) • Bachelor s degree and/or higher-education level or completed coursework in business or health services administration, or equivalent experience • 3 years of Revenue Cycle experience with a specialized focus on Financial Clearance • Proven experience with staff recruiting and management • Strong and broad understanding of Revenue Cycle Operations within a healthcare setting • Mathemati...