What are the responsibilities and job description for the Patient Financial Clearance, Supervisor position at Care New England?
Job Summary:
The Patient Financial Clearance Supervisor plays a critical leadership role in overseeing a team of Patient Financial Clearance Specialists, ensuring the efficient management of authorization processes for surgical procedures and patient admissions. This position is key to the organization's financial stability and operational success, as it directly impacts the timeliness of authorizations, cost estimates, and regulatory compliance. The supervisor will provide guidance, mentorship, and oversight to the team, ensuring high-quality services are delivered to both patients and clinicians. With a strong focus on operational efficiency and performance optimization, this role is essential in maintaining the organization’s compliance with federal regulations, particularly the No Surprises Act, while safeguarding accurate and timely financial estimates for patients and departments.
Duties and Responsibilities:
Approve and monitor employee timecards, paid time off (PTO), and sick leave requests. Ensure the department is consistently staffed to meet operational needs by tracking team availability and coverage. Report any staffing issues or concerns to the management team promptly, ensuring appropriate action is taken to maintain workflow and productivity.
Lead and manage the day-to-day operations of the Financial Clearance Specialist team. Provide direction, training, and support to ensure the team meets departmental goals and objectives.
Oversee the submission of Notices of Admissions (NOA) to payers, securing surgical authorizations, verifying that all required authorizations are on file, and patient estimates are correctly finalized. Ensure the team is meeting timelines and handling tasks efficiently.
Ensure that the team adheres to all federal regulations, including the No Surprises Act, and maintains compliance with payer policies and organizational guidelines.
Regularly assess team performance, provide constructive feedback, and implement strategies to improve performance. Prepare reports on team productivity and compliance metrics for senior management.
Conduct training sessions to ensure staff is up-to-date with authorization processes, payer requirements, and regulatory changes. Foster continuous professional development within the team.
Act as a liaison between the Financial Clearance team, providers, and insurance companies to resolve any issues or discrepancies related to authorizations or patient cost estimates.
Address complex issues related to authorization, billing, and patient cost estimates. Ensure effective resolution of escalated concerns from patients, providers, or payers.
Monitor team activities for accuracy, ensuring the proper documentation of authorizations and accurate cost estimates for patients. Identify opportunities for process improvement and implement best practices.
Perform other duties as assigned
Requirements:
Associate degree required; bachelor’s degree preferred
5-7 Years Of Experience Working Within Healthcare Required
3-5 years of experience in financial clearance and/or prior authorization and/or pricing estimates and/or medical billing, with at least 1-2 years in a supervisory role.
Americans with Disability Act Statement: External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis.
EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status
Ethics Statement: Employee conducts himself/herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.
The Patient Financial Clearance Supervisor plays a critical leadership role in overseeing a team of Patient Financial Clearance Specialists, ensuring the efficient management of authorization processes for surgical procedures and patient admissions. This position is key to the organization's financial stability and operational success, as it directly impacts the timeliness of authorizations, cost estimates, and regulatory compliance. The supervisor will provide guidance, mentorship, and oversight to the team, ensuring high-quality services are delivered to both patients and clinicians. With a strong focus on operational efficiency and performance optimization, this role is essential in maintaining the organization’s compliance with federal regulations, particularly the No Surprises Act, while safeguarding accurate and timely financial estimates for patients and departments.
Duties and Responsibilities:
Approve and monitor employee timecards, paid time off (PTO), and sick leave requests. Ensure the department is consistently staffed to meet operational needs by tracking team availability and coverage. Report any staffing issues or concerns to the management team promptly, ensuring appropriate action is taken to maintain workflow and productivity.
Lead and manage the day-to-day operations of the Financial Clearance Specialist team. Provide direction, training, and support to ensure the team meets departmental goals and objectives.
Oversee the submission of Notices of Admissions (NOA) to payers, securing surgical authorizations, verifying that all required authorizations are on file, and patient estimates are correctly finalized. Ensure the team is meeting timelines and handling tasks efficiently.
Ensure that the team adheres to all federal regulations, including the No Surprises Act, and maintains compliance with payer policies and organizational guidelines.
Regularly assess team performance, provide constructive feedback, and implement strategies to improve performance. Prepare reports on team productivity and compliance metrics for senior management.
Conduct training sessions to ensure staff is up-to-date with authorization processes, payer requirements, and regulatory changes. Foster continuous professional development within the team.
Act as a liaison between the Financial Clearance team, providers, and insurance companies to resolve any issues or discrepancies related to authorizations or patient cost estimates.
Address complex issues related to authorization, billing, and patient cost estimates. Ensure effective resolution of escalated concerns from patients, providers, or payers.
Monitor team activities for accuracy, ensuring the proper documentation of authorizations and accurate cost estimates for patients. Identify opportunities for process improvement and implement best practices.
Perform other duties as assigned
Requirements:
Associate degree required; bachelor’s degree preferred
5-7 Years Of Experience Working Within Healthcare Required
3-5 years of experience in financial clearance and/or prior authorization and/or pricing estimates and/or medical billing, with at least 1-2 years in a supervisory role.
Americans with Disability Act Statement: External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis.
EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status
Ethics Statement: Employee conducts himself/herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.
