Patient Financial Services & Prior Authorization Manager

Woodbury, MN

Requestion Number: PATIE01345

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Posted on July 15, 2021

Personal Growth. Expansion. Teamwork. Innovation. Be a part of a truly patient-first environment and an organization that cares about their employees.

Under the direct supervision of the Revenue Cycle Director, the Patient Financial Services/Prior Authorization Manager will be responsible for oversight of the Patient Financial Services Coordinators.
Responsible for ensuring optimal and accurate completion of insurance authorization through leadership of the Patient Financial Services team. This includes overseeing authorization denials, queue management, developing and maintaining departmental policies and procedures in accordance with organizational and insurance industry standards.

  • Provides leadership to the PFS team members by ensuring efficient and effective daily workflow. Oversees initial orientation and manages ongoing productivity, competencies and productivity of team. 
  • Performs managerial functions including time card reconciliation, PTO requests, productivity monitoring, staff recruitment/hiring, performance reviews, training and employee auditing. 
  • Develops and manages ongoing review of department processes, procedures, and workflows and identify opportunities for improvement based on organizational and industry standards. 
  • Work closely with revenue cycle team members to continuously review department processes, procedures, and workflows, continual maintenance of payer requirement tools and identify opportunities for improvement.
  • Oversee the insurance bundling and special surgical services billing and claim processing. Maintain current knowledge regarding third-party and first-party payment procedures and regulations.
  • Work with clinical leadership and provider teams to create cohesive order placement and authorization workflows.

Summit Health ASO, provides administrative and clinical support to our full spectrum of orthopedic care services in our sub-specialty clinics, walk-in care at our OrthoQUICK clinics, imaging, bracing, therapy, surgery, and post-surgical stays at our Care Suites. Our expert teams are part of the 800+ employees who partner to provide quality services and care designed to support a healthier, more active lifestyle.

Summit Orthopedics is committed to providing equal opportunity to all employees and applicants for employment in accordance with all applicable laws and regulations of federal, state and local governing boards and/or agencies.

 

Education

  • Preferred: Bachelors in Health Administration

Experience

  • Preferred: Bachelors degree in related field preferred, or comparable level of experience or education/experience.
  • Required: Minimum of 2 years of supervisory experience in a Business Office setting is required. Demonstrated ability to lead a team. Experience in working both reimbursement and front office preferred. Proficient in Excel, Word and other Office programs.