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Manager Financial Clearance


At Lancaster General Health, our culture is what sets us apart and creates a lasting impression of our health system in the community and in the hearts of our patients and their families. A role with us is more than just a job, we ask that you Live Your Legacy at LGH by finding your passion in your everyday role, committing to those you serve, and reaching for your personal best.

We are recognized as 1 of only 9 hospitals in the entire country with awards in Medicare.Gov, LEAPFROG and Healthgrades Americas 50 Best Hospitals. We have attained five year Magnet ® recognition status for the fifth time with the American Nurses’ Credentialing Center (ANCC) and we are the 2018 recipient of the Foster G. McGaw Prize in recognition of the commitment to community service.

PENN MEDICINE LANCASTER GENERAL HEALTH offers a comprehensive benefits package:

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program so that our employees can stay actively engaged and committed to living their legacy every day. Together, we will continue to make medical advances that help people live longer, healthier lives.

Join us and be part of a team that empowers you to do more than your job and encourages you to:

Live Your Passion. Live Your Best. Live Your Commitment. Live Your Legacy.

Summary

Job Description

HOURS: Full Time (1.0 FTE; 40hrs/wk). Majority of position can be work from home with occasional office hours.

POSITION SUMMARY: Responsible for oversight of the day to day and strategic operations of Pre-Arrival Services and the Financial Clearance.  Demonstrates dynamic ability to adapt to ongoing changes within the health insurance industry in order to effect and implement positive changes for the financial growth of Lancaster General Health.  Keeps well informed of regulatory requirements/changes concerning MA, Medicare and third party payors. Ensures compliance with hospital policies, billing guidelines, and payer policies. 

ESSENTIAL FUNCTIONS: Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:

  • Maintains an understanding of the entire revenue cycle; maintains a thorough knowledge of the work of the Pre-Arrival Services and Financial Clearance Teams; maintains a thorough knowledge of staff processes at a manager level; anticipates and adjusts to changes in the department workflows based on changes in the payer policies and billing guidelines.
  • Identifies work processes that can be improved upon, eliminated, or handled through electronic processes; breaks down identified problems into small components, understands underlying issues, simplifies complex issues; understands the difference between critical and unimportant facts/details.  Identifies efficiencies between the departments that are under this management structure.  Facilitates change to workflow design as able.
  • Ensures department compliance with hospital policies, payer policies, and billing guidelines; develops, maintains and implements policies and procedures; manages process improvement and quality assurance.
  • Develops and utilizes reports, metrics and real time statistics to monitor department quality, effectiveness and efficiency.  Utilizes this data to strategically determine how to grow the coverage scope of the departments they manage and improve denial rates.
  • Develops working relationship with physician practices and all appropriate internal and external departments to provide foundation for efficient financial clearance and reduction of denials.  
  • Manages projects in collaboration with Information Services (IS); monitors and ensures IS compliance and support of project needs; identifies any system dysfunction or discrepancies and makes recommendations for resolving; contributes to and/or leads projects requiring high levels of internal customer interaction, coordination, strategization; develops implementation plans to include timelines and deliverables.
  • Communicates regularly with staff and others, as appropriate, to develop and facilitate timely and accurate information through staff meetings, emails, huddles, and follow-up procedures.
  • Identifies areas for improvement of existing operational policies and SOPs utilizing LEAN methodology and follows through with implementation of changes to improve operational efficiency and patient satisfaction. 
  • Assists the Director in managing the department budget.  Manages functional operations that are consistent with budget allocations, reviews, evaluates and reports on expenditures for cost centers.  Review reports that routinely monitor and ensure compliance to fiscal budget.

SECONDARY FUNCTIONS: The following duties are considered secondary to the primary duties listed above:

  • Reviews, audits, and analyzes problematic accounts and providers direction for corrections, education, and policy updates.
  • Participates in administrative meetings, committees, and project teams as determined necessary.
  • Other duties as assigned.

MINIMUM REQUIRED QUALIFICATIONS:

  • Bachelor’s degree in health care, or related experience.
  • Two (2) years of management experience in insurance or related healthcare position.
  • Three (3) years of experience in acute care or health insurance environment.
  • Three (3) years of experience working with physicians, staff and executive staff.
  • Strong interpersonal skills.
  • Strong written and verbal communication.
  • Strong analytical abilities.

PREFERRED QUALIFICATIONS:

  • Knowledge of the Revenue Cycle.
  • Master’s degree.
  • Five (5) years clinical/hospital experience.

This position is located in Lititz, PA. #LI-MD1

Benefits of Joining Penn Medicine Lancaster General Health:

PENN MEDICINE LANCASTER GENERAL HEALTH combines a Nationally Ranked Hospital with great schools, safe neighborhoods, affordable housing, local community events and festivals as well as a wealth of cultural and recreational activities. The scenic Susquehanna River Valley provides opportunities for fishing, skiing, kayaking, hiking and mountain biking in addition to easy access to NJ shoreline or Delaware beaches. Urban life is easily accessible, with New York, Baltimore, Philadelphia and Washington D.C. a train ride away. Local universities, Fulton Theatre, the downtown shopping and dining district and local sports teams make Lancaster a great place to Live, Work and Play.

Disclaimer

PENN MEDICINE LANCASTER GENERAL HEALTH is an Equal Opportunity Employer, committed to hiring a diverse workforce. All openings will be filled based on qualifications without regard to race, color, sex, sexual orientation, gender identity, national origin, marital status, veteran status, disability, age, religion or any other classification protected by law.

 

Search Firm Representatives please read carefully: PENN MEDICINE LANCASTER GENERAL HEALTH is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, all resumes submitted by search firms to any employee at PENN MEDICINE LANCASTER GENERAL HEALTH via-email, the Internet or directly to hiring managers at Penn Medicine Lancaster General Health in any form without a valid written search agreement in place for that position will be deemed the sole property of PENN MEDICINE LANCASTER GENERAL HEALTH, and no fee will be paid in the event the candidate is hired by PENN MEDICINE LANCASTER GENERAL HEALTH as a result of the referral or through other means.

MILL Full Time Posted on 11/08/2021