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Director, Pre-Access

Job ID: 4668570
Updated: December 6, 2018
Geographic Location: 
Department: Insurance Authorization
Full/Part Time: Full-Time
Shift: Days
Standard Hours: 40
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Job Summary

The Director, Pre-Access is responsible for leading a functional pre-access team across multiple markets. They are responsible for setting performance and effectiveness expectations in line with industry best practices and driving accountability through responsibility of team production and quality measures. The director will be responsible for establishing, monitoring, and meeting key performance indicators aligning to industry best practices for their functional area. The director also partners with non-centralied areas who perform their own pre-access functions to ensure education, training, and adherance to standardized processes. As a subject matter expert, this person must provide leadership and contributes to the overall revenue cycle goals and is responsible for meeting the mission and organizational goals of Ensemble Health Partners, as well as meeting regulatory compliance requirements. The Director, Pre-Access will work closely with other revenue cycle and facility leadership to understand upstread/downstream impacts of workflow and processes, and takes the "big picture" approach to problem-solving and mitigating front-end denials.

Establishes department strategy, direction, and breakdown of department assignments by leader. Leads pre-access managers who lead their functions across the pre-access teams, focusing on standardization, consistency, and best practices.

Partners with other revenue cycle and facility leaders within their scope to ensure upstream/downstream impacts of workflow, and to establish positive relationships while fostering open two-way communication. Serves as the face of the pre-access team to our internal business partners in regards to their service line (IP/OP/Surg).

Coaches and develops department managers. Helps managers use reporting and analytics to find trends, develop action plans, and implement process improvement. Leads managers through denial reviews to find gaps in workflow and processes, and implements strategy to mitigate.

Audits accounts and reviews denials to ensure effectiveness of workflow processes in place, and collaborates with upstream/downstream impacts to improve process based on findings.

Ensures adherence to departmental budget.  Prepares monthly reports as requested.  Establishes departmental goals with the staff to optimize performance and meet budgetary goals while improving operations to increase customer satisfaction and meet financial goals of the organization.

Performs other duties as assigned.

Qualifications - Minimum

Required minimum education: 4 year / Bachelors Degree

Preferred education: Graduate Degree

* Combination of post-secondary education and experience will be considered in lieu of a degree.

Minimum years and type of experience:

7+ years leadership experience in a revenue cycle, healthcare related role, with extensive experience with insurance payer benefits and authorization processes. Experience with ownership of daily workflow management, developing leaders, and setting department strategy.

Experience with Epic. Experience with building reporting and analytics to monitor performance and drive process improvement.

Excellent organizational skills.  Patient Access experience with managed care/insurance, formal typist with a minimum of 45 WPM, intermediate to expert proficiency in MS applications (Word, Excel & PowerPoint), experience with multiple computer systems and use of dual screens. Able to multitask and work individually while applying critical thinking skills.  Customer Service experience highly preferred.


Full-time, 40 hours per week, days, 8:00 a.m. to 5:00 p.m.





Equal Employment Opportunity

It is our policy to  abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a), prohibiting discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibiting discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity, or national origin.

About Us

This position will be a part of the revenue cycle team at Ensemble Health Partners - a wholly owned subsidiary of Mercy Health. Ensemble Health Partners specializes in providing revenue cycle solutions and creating real value for its clients by building relationships, reducing revenue cycle spend and delivering exceptional results. Ensemble partners with hospitals across the United States to make real and lasting improvements that impact the bottom line.

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