Role Description Responsible for overseeing strategic direction of financial clearance operations and ensuring integration with enterprise revenue cycle objectives. Provides leadership to optimize workflows, strengthen compliance, and drive performance outcomes across eligibility, benefits verification, estimates, and authorization functions. Ensures collaboration with cross-functional partners to reduce denials, improve patient experience, and support organizational financial health. Develops process improvements, monitors key metrics, and advances operational excellence. Essential Functions - Oversees financial clearance operations, including eligibility, benefits verification, estimates, and prior authorization activities. - Directs supervisory staff, monitors performance, and ensures consistent coaching and development. - Establishes and enforces compliance with payer requirements, HIPAA, and organizational policies. - Collaborates with revenue cycle, clinical, and scheduling leaders to address complex clearance or authorization issues. - Analyzes key performance indicators, trends, and denial data to inform strategy and resource allocation. - Leads implementation of process improvements and technology enhancements to optimize efficiency and accuracy. - Serves as an escalation point for high-level payer, provider, or patient inquiries. - Guides departmental budgeting, staffing, and resource planning to achieve service-level and financial goals. - Ensures staff training and readiness for changes in payer guidelines, system updates, and clearance protocols. - Mentors and develops leaders within the financial clearance team to strengthen succession planning and promote staff growth. - Performs other duties as assigned. Qualifications - Bachelor’s degree - 6-7 years of experience - An equivalent combination of education and experience may be considered. - All experience must be paid and in the same related field. - Part-time and PRN experience will be prorated based on hours worked per week. - Volunteer work and internships for academic credit are not counted. Requirements - Certifications & Licensures: N/A Working Conditions - Lifting, pushing, and/or pulling objects up to 50lbs: Occasional (< 10% of the time) - Lifting, pushing, and/or pulling objects over 50lbs: Never - Standing or walking with objects up to 10lbs: Intermittent (10% - 50% of the time) - Standing or walking with objects up to 25lbs: Occasional (< 10% of the time) - Sitting at the computer workstation for extended periods: Intermittent (10% - 50% of the time) - Risk of back injury from moving, lifting or positioning patients, equipment, or materials: Occasional (< 10% of the time) - Repetitive motion: Intermittent (10% - 50% of the time) - Working at heights above 4 feet: Never - Working in confined spaces: Never - Risk of injuries from use of equipment on the job: Occasional (< 10% of the time) - Job-related travel: Occasional (< 10% of the time) - Loud noises: Never - Temperature extremes: Never - Hazardous chemicals and fumes including waste: Occasional (< 10% of the time) - Radiation: Never - Burns: Never - Cuts/Punctures: Occasional (< 10% of the time) - Bloodborne/airborne pathogens: Occasional (< 10% of the time) - Recombinant DNA or viral vectors: Never - Combative/violent people: Never - Animal handling (including carcasses): Never Physical Demands This position requires intermittent sitting at a computer workstation for extended periods of time; performing tasks with repetitive motions (such as typing); intermittent standing or walking with objects weighing up to 10 pounds; occasional standing or walking with objects weighing up to 25 pounds; and occasional lifting, pushing, or pulling objects weighing up to 50 pounds. Department - Clearance Shift - Days (United States of America) Time Type - Full time Address - 2201 Lexington Ave - Ashland, Kentucky