Manager, Pre-Access Services
Summary
Oversee operations of scheduling, insurance verification, authorization/referrals, and financial clearance departments.
Essential Duties and Responsibilities
These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned.
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Provides day-to-day operational leadership for Pre-Access Services, including staffing, performance management, and employee relations.
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Oversees hiring, onboarding, training, evaluations, and disciplinary processes.
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Serves as a liaison between patients, families, providers, and internal teams to ensure coordination of care.
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Ensures compliance and quality control standards are consistently met across all functions.
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Acts as a subject matter expert (SME) on diagnostic procedures, workflows, and patient access processes.
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Leads and supports scheduling operations for multiple tests and procedures to maximize efficiency.
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Partners with clinical teams to optimize schedules, resource utilization, and revenue outcomes.
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Maintains and updates scheduling templates, protocols, and workflow instructions.
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Serves as an SME on insurance, including coverage, authorizations, and payer requirements.
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Applies knowledge of ICD coding, medical necessity, and patient financial communication (e.g., ABNs).
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Monitors industry trends and payer changes to ensure ongoing compliance and best practices.
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Utilizes reporting and dashboards to drive performance, productivity, and ≥96% accuracy standards.
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Leads customer service and service recovery efforts to enhance patient experience.
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Provides hands-on support, staff mentoring, cross-coverage, and technical guidance as needed.
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Drives employee engagement and retention while maintaining a consistently professional presence and communication style.
Supervisory Responsibilities
Reports to: Pre-Access Services
Supervises: Schedulers, Financial Services Rep, Verifiers, Pre-Registration, Authorization Coordinators
Responsibilities:
Responsible for the daily operations, quality, and service of the Pre-Access Services department, including but not limited to Central Scheduling, Pre-Registration, Insurance Verification, Authorization/Referral Management, and Financial Clearance for hospital-based services. This role includes oversight of the high-volume Patient Access Contact Center that services patients seeking care with various entities using multiple scheduling/registration/billing platforms. This role also includes all aspects of financial clearance (estimates, insurance verification, auth/referral, pre-service payments, financial assistance, etc.). Ensures the department exemplifies service excellence, professionalism, and responsiveness to both internal and external customers. Provides leadership and administers human resource policies and practices in a multi-skilled, multi-functional environment.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and Experience
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Minimum Required Education: Bachelor’s Degree; Four (4) years of management experience will be considered in lieu of degree.
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Preferred Education: Master’s degree
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Experience: 5 years of experience within a healthcare revenue cycle setting required. One year experience with Epic EMR is required.