Director of Financial Clearance

Johns Hopkins Medicine • Baltimore, MD

8d

About The Position

The Financial Clearance Shared Services Center performs the financial clearance function for outpatient procedures/surgeries, inpatient admissions, and clinical trials at multiple Johns Hopkins Medicine entities, including The Johns Hopkins Hospital, The Johns Hopkins Outpatient Center, The Johns Hopkins School of Medicine, Bayview Medical Center, Sibley Memorial Hospital, Suburban Hospital, Johns Hopkins All Children’s Hospital, and a number of outpatient satellite clinics. Critical to the success of this position, the Financial Clearance Director, Revenue Cycle Management is responsible for all aspects of the Financial Clearance Shared Services operations to include but not limited to: Establishing programs, protocols, policies and procedures to support the financial clearance process and working with all entities to standardize processes. Developing and analyzing reports to assist management to enhance revenue cycle performance and maximize operational efficiencies. Implementing strategies designed to improve the effectiveness of the financial clearance process through increased automation and controls. Responsible for regulatory and compliance activities associated with the financial clearance process and ensuring compliance with Revenue Cycle Management policies and procedures. The incumbent must also possess the ability to ensure that appropriate communication is maintained across all entities and specialties (administrators, ambulatory clinic managers, physicians, Office of Managed Care, utilization review, Finance directors, third-party payers, and patients) to ensure all information is obtained to secure appropriate insurance authorization and/or payments prior to services being performed. This position is responsible for managing the inpatient and outpatient financial clearance component of the Revenue Cycle for multiple entities and, as such, must establish relationships at all facilities and be familiar with each institution’s registration/scheduling practices and payer contracts, although they may not be under the direct control of the incumbent. In addition, knowledge of managed care and regulations impacting patient accounting, as well as the ability to integrate activities under his or her direct control with the overall Revenue Cycle Management function, are essential elements of this function.

Requirements

• Requires Bachelor’s Degree in Accounting, Business Administration, Finance, or a related field.
• A minimum of ten (10) years of hospital receivables/operations management experience within a large academic medical center or health system, with at least six (6) of those years in a management capacity.
• Prior work experience must include revenue cycle management projects and/or responsibilities, and a significant role in a redesign project and/or management experience working in a highly automated, centralized business office environment.

Nice To Haves

• A Master’s Degree in Business Administration, Health Administration, or Information Management is preferred.
• CRCE/CMPA/CHFP certification preferred, leadership role in industry organizations such as HFMA, AAHAM, or MHA strongly encouraged.

Responsibilities

• Establishing programs, protocols, policies and procedures to support the financial clearance process and working with all entities to standardize processes.
• Developing and analyzing reports to assist management to enhance revenue cycle performance and maximize operational efficiencies.
• Implementing strategies designed to improve the effectiveness of the financial clearance process through increased automation and controls.
• Responsible for regulatory and compliance activities associated with the financial clearance process and ensuring compliance with Revenue Cycle Management policies and procedures.
• Ensure that appropriate communication is maintained across all entities and specialties to ensure all information is obtained to secure appropriate insurance authorization and/or payments prior to services being performed.
• Managing the inpatient and outpatient financial clearance component of the Revenue Cycle for multiple entities

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees