Financial Verification Manager
WFA Digital Insight
The demand for skilled financial verification professionals in the healthcare sector has seen significant growth, with a 25% increase in job postings over the last year. As a Financial Verification Manager at Clinical Health Network for Transformation, you'll be at the forefront of ensuring seamless financial clearance processes, leveraging your expertise in Excel and team management. With the healthcare industry's ongoing shift towards remote and digital solutions, candidates with strong analytical and communication skills are in high demand. Before applying, consider how your experience aligns with CHN's mission to advance health equity and your ability to work effectively in a remote environment.
Job Description
About the Role
The Financial Verification Manager role at Clinical Health Network for Transformation (CHN) is a critical position that oversees the financial verification process, ensuring that patients receive the care they need while maintaining the financial integrity of the organization. Reporting to the Director of Patient Access, this manager will supervise a team of financial verification specialists, providing guidance and support to ensure all administrative and technical functions of financial verification are handled efficiently and effectively. The role is part of a collaborative effort across Planned Parenthood affiliates in the United States, aiming to bring high-quality, affordable care to every member of the community.The day-to-day responsibilities of this role involve managing the financial clearance and insurance inquiry services, including preauthorization procurement, proactive financial coverage screening, complex insurance questions, and benefits verification. The manager will also be responsible for reviewing and interpreting denial reports, manual insurance verification reports, and other necessary documents to ensure compliance with federal, state, and third-party regulatory requirements.
As a key member of the Patient Access team, the Financial Verification Manager will act as a liaison between patients, providers, and payers, addressing financial verification issues and advocating for the patient, provider, and CHN. This role requires a deep understanding of the healthcare industry, excellent communication skills, and the ability to work effectively in a remote environment.
What You Will Do
- Supervise a team of Financial Verification Specialists to ensure all administrative and technical functions of financial verification are being handled efficiently and effectively
- Maintain competence to resolve direct consumer interactions, including determining eligibility for services, providing price estimates, creating and maintaining payment plans, and addressing patient complaints
- Ensure the financial verification team is appropriately staffed with trained employees
- Serve as a liaison with patients, providers, and payers related to financial verification issues
- Act as an advocate for the patient, provider, and CHN relative to compliance with federal, state, and third-party regulatory requirements
- Demonstrate an elevated level of integrity and innovative thinking, contributing to the success of the organization
- Participate in the development and implementation of CHN’s improvement and operations initiatives
- Measure and coach on departmental productivity, performance, and improvement opportunities
- Hire, direct, coach, and evaluate the performance of all direct reports to develop and support a high-performance team
- Problem-solve escalated concerns from CHN member affiliate health centers and/or patients
- Drive innovation in front-end methods and processes to lower operational costs and improve AR, transaction times, screening rates, and approval rates with affiliate partners
What We Are Looking For
- Experience in financial verification or a related field, preferably in a healthcare setting
- Strong understanding of insurance verification, billing, and regulatory requirements
- Proven leadership and team management skills, with the ability to motivate and develop team members
- Excellent communication and interpersonal skills, with the ability to work effectively with patients, providers, and payers
- Strong analytical and problem-solving skills, with the ability to interpret data and make informed decisions
- Proficiency in Excel and other Microsoft Office applications
- Experience with electronic health records (EHRs) and practice management systems (PMS)
- Knowledge of federal, state, and third-party regulatory requirements
Nice to Have
- Certification in medical billing or coding (e.g., CPC, CMC)
- Experience with revenue cycle management and patient access operations
- Knowledge of healthcare compliance and regulatory requirements
- Experience working in a remote or virtual environment
Benefits and Perks
- Competitive salary and benefits package
- Opportunity to work with a leading healthcare organization committed to advancing health equity
- Collaborative and dynamic work environment
- Professional development and growth opportunities
- Flexible remote work arrangements
- Access to cutting-edge technology and tools
- Comprehensive health insurance and retirement benefits
How to Stand Out
- Ensure your resume and cover letter highlight your experience with financial verification, team management, and Excel proficiency.
- Prepare to discuss specific scenarios where you've successfully resolved complex financial verification issues or improved team productivity.
- Show a deep understanding of the healthcare industry and regulatory requirements, and be ready to explain how you stay updated on changes and developments.
- Demonstrate your ability to work effectively in a remote environment, including your experience with virtual communication tools and self-motivation strategies.
- Be prepared to provide examples of how you've driven innovation and process improvements in previous roles, and how you plan to contribute to CHN's mission and goals.
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