Director of Authorization-Patient Financial Services Mount Sinai Health System-Corporate 42nd Street Full-Time-Days

Director of Authorization-Patient Financial Services Mount Sinai Health System-Corporate 42nd Street -Full-Time-Days

The Director Health System Authorization is for the Mount Sinai Health System (MSHS) and the Icahn School of Medicine at Mount Sinai (ISMMS) (which includes the MSHS and the Faculty Practice Plan) is accountable for authorization across the medical center. The Director will report to the Senior Director Financial Clearance of the MSHS.

The Director of Authorization is a key leader within the Revenue Cycle Management team responsible for overseeing all aspects of authorization across the healthcare system. This includes inpatient outpatient professional and ambulatory care settings. The director is charged with ensuring accurate and timely patient authorization and insurance data collection compliance with regulatory requirements and front-end revenue integrity. The role plays a critical part in driving operational excellence enhancing the patient experience and supporting the financial health of the organization.

Direct daily operations of the patient authorization function for hospital ambulatory care and practice settings.

Ensure authorization workflows align with revenue cycle best practices to reduce claim denials improve cash collections and enhance clean claim rates.

Develop and implement policies and procedures that promote efficiency data integrity and regulatory compliance (e.g. HIPAA CMS).

Monitor key performance indicators (KPIs) such as authorization accuracy turnaround times and patient scheduling delays due to pending authorizations; analyze trends and initiate performance improvement plans as needed.

Collaborate with departments such as billing coding IT clinical operations and compliance to ensure a seamless authorization process that expedites patient care.

Lead coach and mentor a team of managers supervisors and front-line authorization staff; oversee training performance evaluations and staff development.

Maintain strong internal controls and audit readiness for all authorization-related processes.

Support organizational goals related to patient satisfaction clinical efficiency and access to care.

Utilize revenue cycle and EHR systems effectively.

Organize routine meetings with health system business leaders and managed care teams to review authorization performance payer issues and denials.

Build effective collaborative relationships with key stakeholders across departments (e.g. DTP Human Performance Managed Care Finance and clinical departments).

Collaborate with Finance Managed Care and DTP contributors to develop and operationalize optimal authorization performance and trending.

Provide leadership and support governance processes to ensure effective efficient standardized and compliant practices across MSHS.

Investigate and resolve denials; coordinate efforts to assist senior revenue cycle leaders in developing innovative strategies and solutions.

Work closely with clinical leaders and department administrators to provide education industry best practices and recommendations on authorization and insurance verification.

Establish and maintain strong working relationships with Revenue Cycle leaders hospital and department leaders and key strategic partners.

Maintain a strong understanding of revenue performance metrics and payer mix; lead the team in building plans to support operational departments in achieving best practice performance through analytics process improvement and technology enhancements.

Maintain strong customer relationships with key strategic partners.

Ensure appropriate functional strategic partners are engaged throughout the process.

Monitor and provide regular reporting to senior management on key performance metrics (e.g. actual vs. expected results for financial targets).

Bring developing issues and recommended actions to the attention of senior leadership and governance committees.

Develop maintain and ensure compliance with standardized policies processes and programs across MSHS.

Develop a high-performing team measured by benchmark process outcomes audit and compliance results financial goals and employee satisfaction.

Stay current with government regulations regarding patient access authorization and insurance.

Establish goals objectives and budgets for assigned areas; monitor and manage to ensure achievement once approved.

Ensure all HIPAA privacy and security standards are adhered to.

Conform to established policies procedures processes and Standards of Behavior; ensure assigned staff do the same.

Perform other duties as assigned.

Education

• Bachelors degree in finance or Business-related field; Masters preferred

Experience

• 5 years of progressively responsible experience in patient access that includes experiences in registration financial clearance and insurance verification.
• Extensive demonstrated success in a revenue cycle/finance department in a large not-for-profit/academic health system facility or corporate environment.
• Excellent interpersonal skills experience with making presentations to and dealing with senior management and other C-suite leaders.
• Financial management skills including the ability to analyze financial data for operations budgeting auditing forecasting accounting AR and reserve analysis market analysis staffing and financial reporting.
• Strong leadership skills to motivate cross-departmental teams performance towards excellence using team concepts and consensus-building management styles.
• Advanced/ effective interpersonal written/ verbal communication and presentation skills along with the ability to communicate complex finance concepts to others without a finance background.
• Demonstrated ability to engage in positive powerful persuasion with individuals or groups with diverse opinions and/ or agendas leading to outcomes that meet identified goals.
• Ability to analyze and resolve complex problems necessary to develop and administer multifaceted revenue processes regardless of whether issues originate in an area under direct or indirect control.
• Ability to enlist cooperation and build teams committed to carrying out initiatives in environments that may be resistant to change and not under the incumbents direct authority.
• Ability to translate key performance indicator levels into a finance-based business case then design implement and manage more effective/ efficient processes.
• The ability to maintain a high level of positive energy/ creativity during periods of elevated work demands.
• Ability to prioritize multiple objectives in a rapidly changing environment and deliver quality outcomes.
• Ability to develop and maintain effective relationships at all levels throughout the organization.
• Strong Leadership skills.
  

Working Conditions:
Corporate office environment in an academic health system.

518 - PFS 633 Third Avenue - MSH Mount Sinai Hospital