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A National Cancer Institute (NCI)-designated Comprehensive Cancer Center since 2001.
Summary
Position Highlights:
The Manager, Financial Clearance Unit is responsible for providing leadership, planning, organizing and has general oversight of the Financial Clearance functions for the Facility and Moffitt Medical Group: New Patient Registration and Benefits verification, all aspects of Eligibility, Verification and Payer Authorization, Medical Necessity, Financial Counseling, Financial Assistance and Patient Navigation, Price Estimations, Pre-service Collections and Front-End Denials.
A successful Manager, Financial Clearance Unit has a clear understanding of revenue cycle processes, payer guidelines, managed care contracts, billing, collections, patient assistance programs, denials management and estimation for oncology patients. This position holds key responsibilities with direct impact in reimbursement and patient satisfaction.
The Manager, Financial Clearance Unit is responsible for the operation, processes and initiatives of the department to successfully achieve revenue targets and to optimize the patients' journey.
Responsibilities:
- Responsible for all aspects of Eligibility, Verification, Medical Necessity and Payer Authorization for Facility and Moffitt Medical Group
- Responsible for New Patient registration, Benefits verification, Hospital Transfers and Urgent Admissions processes
- Responsible for Financial Counseling, Financial Assistance and Patient Navigation activities for outpatient and inpatient services
- Responsible for Pre-service collections activities for Facility and Medical Group
- Support, oversee and manage the Patient Estimates responsibility
- Responsible for front-end denials management and appeal processes
- Responsible for management of policies, goals and initiatives of the Financial Clearance Unit activities to achieve revenue targets
- Responsible for all aspects of operation in the Financial Clearance Unit to ensure the financial health of Moffitt Cancer Center
Credential and Qualifications:
- Bachelor’s degree in Business Administration, Accounting, IT or related discipline
- Minimum of seven (7) years Healthcare Revenue Cycle or related financial experience; including at least
three (3) years' experience in a leadership, supervisory and/or management role within a business and/or
financial analysis department is required.
- *in lieu of a degree, must be enrolled in a baccalaureate program with completion within 2 years from the date of hire (will be tracked by the department)
- Certification required* CRCR HFMA *within six (6) months from date of hire/transfer will be tracked by the
department.
Minimum Skills/Specialized Training Required:
-Excellent communication and customer service skills, interpersonal ability and demonstrated leadership skills to regularly interact with administration, medical staff, nursing personnel, other hospital professionals, and external health care professionals and payors.
- Excellent problem-solving and conflict resolution skills
- Excellent analytical skills with the ability to summarize and to present data
- In-depth knowledge of health insurance payment processes, including medical necessity, authorization and denials
- Deep understanding of government healthcare programs
- Working knowledge of medical terminology, particularly radiology, surgery, infusion, oncology, BMT, Car-T, Clinical Trials
Certified Revenue Cycle Representative (CRCR) through the Healthcare Finance Management
Association (HFMA) *Must obtain within 6 months from date of hire/transfer. (Certification will be tracked
by the Financial Clearance Unit Department)