Director, Preservice Verification

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🔥 0 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

⏰ Full Time

🔴 Lead

👔 Director

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Duke Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1924

📚 Education

🤝 Non-profit

🌍 Social Impact

Education • Non-profit • Social Impact

Duke Careers is a platform connected to Duke University's rich legacy, established in 1924. It aims to celebrate the centennial of Duke University while providing resources, stories, and interviews that reflect the university's history, current achievements, and future aspirations. A key focus of Duke Careers is to engage with alumni and the community, showcasing the transformative impact of education and leadership within the university.

📋 Description

• Plan, direct and coordinate all activities of Preservice Verification • Identify, communicate and align overall strategy for department improvement across the system • Develop departmental strategies to meet overall PRMO goals and performance metrics • Work with entity leadership, departmental managers, revenue managers, and physicians to identify opportunities for improving revenue cycle performance • Formulate and administer enterprise level policies and procedures; ensuring compliance with state and federal regulations, and all payor requirements • Review monthly trending analysis of denials and write-offs related to registration/eligibility, authorization, and medical necessity • Develop and implement strategies to reduce denials and write-offs • Manage internal control performance for Preservice Verification department and associated functions & workflows • Engage with other departments as needed to ensure compliance • Actively direct outsourcing and vendor relationships • Monitor cost and evaluate utilization of any vendor relationships assigned to department cost center • Assist in identification of new technologies that will improve financial service operations • Manage human capital and resources-onboarding, succession planning, recruitment strategies and employee engagement

🎯 Requirements

• Bachelor’s degree required • Master’s degree preferred • 8 years progressive experience in clinical/administrative/consulting responsibilities in or with a provider or payor healthcare environment is required • 5 years in management of people or projects • Extensive experience working with clinical providers required • Solid understanding of payor coverage requirements related to eligibility, authorization, and medical necessity • Knowledge of procedure/diagnosis coding, and case management/utilization review functions • General understanding of all revenue cycle functions and interrelationships • Strong leadership presence and skills • Proven capabilities in building and leading teams • Ability to work with others in a cooperative, collaborative manner • Strong written and oral communication skills • Epic experience preferred; MS Office Applications (Word, Excel, Visio, Access)

🏖️ Benefits

• Health insurance • Flexible work arrangements • Professional development opportunities