Senior Manager, Financial Clearance\UKHC in Lexington, Kentucky at University of Kentucky

7 yrs

None

This position requires intermittent sitting at a computer workstation for extended periods of time; performing tasks with repetitive motions (such as typing); intermittent standing or walking with objects weighing up to 10 pounds; occasional standing or walking with objects weighing up to 25 pounds; and occasional lifting, pushing, or pulling objects weighing up to 50 pounds.

M-F 8am-5pm, evenings and weekends as required

| The Senior Manager, Financial Clearance is responsible for the operational leadership of Centralized Payer Authorizations. This position will oversee processes to ensure timely and accurate authorizations to support patient care. Authorizations will span outpatient and inpatient care as well as medical equipment necessary for surgical procedures such as implants and special devices. The position will require an in depth understanding of insurance authorization requirements, payer guidelines, and medical necessity across all payer types such as governmental, commercial, managed care, etc. The position will focus on relationship management with physicians and clinic management to support continuous process improvements to improve timely authorization rates and decrease authorization denials. The position will be responsible for partnering with all specialties to incorporate those areas into the centralized model or to provide the Enterprise standard for authorization workflows as well as liaising with Payer Administration and Provider Enrollment for contracting information and enrollment issues. Works in conjunction with Pre-Registration leadership to develop workflows that ensure financial clearance. The Sr. Manager is responsible for: partnering with IT to ensure the development and maintenance of accurate estimates; Enterprise validation and sign off with respect to Payer Platform and authorization automation (RTA) including oversight of the Enterprise ASA tables; workflow design and adherence to Defer & Delay; Enterprise policy pertaining to Authorizations. The position oversees remote managers, supervisors, and insurance authorization specialists. This position will ensure compliance with UKHC policies and procedures as well as Federal, State, and local regulations.

This is a fully remote position.

There is an internal candidate being considered.

Problem Solving, Organization, Data Analysis, Communication, Collaboration

Bachelor’s degree and 6-7 years of progressive experience

We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors, the University of Kentucky is a Tobacco & Drug Free campus.

The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status.

Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.