JOB TITLE: Manager, My Visit Pre-Financial Clearance
LOCATION: Glenmaura Office Building
WORK SCHEDULE:Days (M-F with core hours between 8:30AM – 5:00PM; no weekends or holidays)
WORK TYPE: Full Time (1.0 FTE)
Provides for the centralized management of the MyVisit program (pre-financial clearance program) within the Revenue Cycle of the Geisinger Health System. Manages, and implements programs to insure the efficient operations of the MyVisit program in order to generate sufficient revenue and cash flow to support GHS operations and strategic initiatives. The responsibilities of this position for the MyVisit program include all financial clearance functions which encompasses registration, insurance eligibility checking, pre-certification, medical necessity review, referral authorizations, price estimates, collection of co-payments and deductibles, financial triage and total patient contact prior to the patients clinical encounter. In the position of Manager, MyVisit, responsibilities include managing, formulating new programs, identifying, analyzing, reducing and resolving any Revenue Cycle administrative operational patient related issues. In addition, supervises staff assuring all activity meets the requirements of outside governing/regulatory bodies and third party payers. This program is the driving force associated with the successful resolution of approximately $285 million of hospital and professional accounts receivable. MyVisit is responsible for insuring monthly cash flow of approximately $75 million. These responsibilities also include the management of approximately fifty (50) FTEs in regards to the financial clearance support functions for approximately $2.4 billion of hospital and professional gross revenue and $900 million in net revenue. The annual operating budget is $3.2 million and the MyVisit program is expected to increase GHS net revenue by $12.0 million per year. The MyVisit program will provide financial clearance for approximately 2.5 million clinical encounters on an annual basis.
Responsible to manage the pre-auth review for multiple Geisinger facilities as well as the Clinic enterprise.Auth reviews include but are not limited to hospital scheduled admissions, high end radiology and cardiac imaging services, infused meds, oral meds, sleep studies, pain mgt clinics, and subject to evolving service line request to incorportate Rev Mgt administrative duties under MyVisit.
Reports to Reg. Director Pt. Access GNE.
COMPETENCIES AND SKILLS:
Demonstrates strong presentation skills with the ability to effectively communicate too many different audience levels.
Demonstrates a working knowledge of local market health plans and a general understanding of cost containment concepts
Familiarity with computerized applications is essential.
EDUCATION AND/OR EXPERIENCE:
B.A., B.S. or Master's in related field preferred. Appropriate years of experience will be considered in lieu of degree.
Demonstrates extensive knowledge (i.e. minimum of 3 years) of revenue cycle and/or regulatory requirements as they relate to the Revenue Cycle. Experience preferred within a similar setting of size or volume.
Significant experience with payers, providers, hospitals and physicians and understand the commensurate requirements for facilitating accounts receivable resolution, cash flow, billing and customer service issues required.
Experience within a centralized business office preferred.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Work is typically performed in an office environment.
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
GEISINGER WYOMING VALLEY MEDICAL CENTER: (GWV), located in Wilkes-Barre, Pa., is an acute care hospital that is licensed for 274 beds, and houses the only Level II Trauma center in Luzerne County. The campus includes the Frank M. and Dorothea Henry Cancer Center, The Richard and Marion Pearsall Heart Hospital, the Janet Weis Children’s Hospital Pediatric Unit, a transplant program and the Brain & Spine Tumor Institute. Geisinger South Wilkes-Barre is GWV’s ambulatory campus.
We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.* Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. For more information, visit www.geisinger.org, or connect with us on Facebook, Instagram, LinkedIn and Twitter.
** Does not qualify for J-1 waiver. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
*Domestic partner benefits not applicable at Geisinger Holy Spirit.
Internal Number: 50338
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencing
programs, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.
Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.