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Manager, Financial Clearance

Manager, Financial Clearance

GuthrieSayre, PA, United States
12 days ago
Job type
  • Full-time
Job description

Summary

The Manager of Patient Financial Clearance is responsible for managing the patient financial clearance and patient registration functions across The Guthrie Clinic. This role leads the central authorization team and corporate Medicaid enrollment team. This role ensures that patients are financially cleared for services in a timely, compliant, and patient-centered manner while supporting front-end revenue cycle goals. The Manager develops and leads initiatives to improve pre-service accuracy, reduce denials, streamline workflows, and enhance the patient experience across all points of access. This role reports to the Director Patient Financial Clearance.

Education

Bachelor's degree in business, finance, health or public administration or a related field

Experience

Bachelor's degree or 3 years of progressively responsible and related work experience. This requirement may be satisfied through an equivalent combination of education and 7 years prior experience in healthcare, insurance or retail businesses with responsibility and management of billing and patient collection. Epic experience in a health system or integrated delivery network (IDN). Progressive hospital and physician revenue cycle management experience within high-performing revenue cycle teams

Essential Functions

Leadership & Oversight

  • Provides operational management of : - Centralized prior authorization and financial clearance units
  • Medicaid eligibility and enrollment assistance teams
  • Ensure consistent processes and performance across all facilities and centralized departments

Operational Excellence

  • Establish, monitor, and refine KPIs related to pre-registration, point-of-service collections, insurance verification, authorization turnaround, and enrollment conversion
  • Lead initiatives to reduce registration errors, authorization-related denials, and Medicaid coverage gaps by reducing uninsured or underinsured patients
  • Ensures alignment with health system access standards, compliance policies, and financial assistance programs

    • Patient Access & Experience

  • Promote a positive, empathetic experience for patients at all financial clearance touchpoints
  • Oversee implementation of tools and scripting that improve transparency around benefits, co-pays, authorization and financial responsibilities
  • Collaborate with patient financial services to support early engagement in payment plans or financial counseling

    • Regulatory Compliance & Quality

  • Ensure compliance with regulatory guidelines including CMS, EMTALA, HIPAA, and payer requirements
  • Oversee audit readiness, documentation standards, and training for authorization and eligibility practices
  • Support Medicaid screening and eligibility determinations in accordance with state-specific rules

    • Technology & Innovation

  • Partner with IT and vendor teams to optimize financial clearance systems including EMR, authorization portals, insurance discovery tools, and Medicaid screening software
  • Leverage automation and AI-enabled tools to improve workflow efficiency and reduce manual errors

    • Financial Impact & Strategy

  • Contribute to revenue integrity by ensuring accurate and timely pre-service processes that support downstream billing
  • Monitor and report on financial clearance metrics and identify trends that affect reimbursement or patient satisfaction
  • Lead strategic planning for department growth, scalability, and cross-functional alignment

    • Team Development

  • Hire, train, and develop managers, supervisors, and frontline staff across departments
  • Foster a collaborative, accountable, and mission-driven work culture
  • Implement standardized training programs and continuous improvement models across all sites and teams

    • Key Performance Metrics include :

  • Pre-Service Collection Rate
  • Touchless Arrival Rate
  • Appt Prior Auth Rate
  • Admission Prior Auth Rate
  • Authorization Denial Rate
  • Time of Service Payment Rate

    • Other Duties

    1. Travel for this position is sometimes required.

    2. Participation in community and employee engagement activities is required.

    3. It is understood that this description is not intended to be all-inclusive and that other duties may be assigned as necessary in the performance of this position.

    Upload 9-22-25

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