Title: Supervisor Financial Clearance Location: United States Job Description: SHIFT: Day (United States of America) Seeking Breakthrough Makers Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation. At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care-and your career. CHOP does not discriminate on the basis of race, color, sex, national origin, religion, or any other legally protected categories in any employment, training, or vendor decisions or programs. CHOP recognizes the critical importance of a workforce rich in varied backgrounds and experiences and engages in ongoing efforts to achieve that through equally varied and non-discriminatory means. A Brief Overview Are you ready to take the next step in your career and lead a team that makes a real impact on patient care and hospital success? We're looking for a Supervisor of Financial Clearance to join our dynamic team. In this role, you'll ensure patients and families have access to CHOP providers and treatments with confidence in both quality and cost, while driving operational excellence and financial integrity. Why This Role Matters As Supervisor, you'll oversee a talented team responsible for insurance verification, prior-authorization, price estimation, and medical necessity validation. You'll partner with leadership and payors to streamline authorizations, prevent administrative denials, and maximize reimbursement-helping CHOP deliver exceptional care while maintaining financial sustainability. What's In It for You - Leadership Growth: Develop your management skills by leading a high-performing team and influencing key financial processes. - Professional Development: Gain deep expertise in payor policies, contract terms, and revenue cycle operations. - Collaborative Culture: Work closely with internal teams and external partners in a supportive, mission-driven environment. - Impactful Work: Your efforts directly improve patient experience and strengthen CHOP's financial health. - Healthcare Financial Management Association (HFMA) Membership & benefits Key Responsibilities - Lead and mentor the Financial Clearance team. - Ensure timely and accurate completion of authorizations and precertification. - Monitor quality and implement process improvements. - Communicate pricing and insurance details with professionalism and empathy. - Partner with Epic teams to troubleshoot system delays and remain informed on upcoming updates and enhancements. Ideal Candidate - Deep knowledge of healthcare financial operations, including medical billing and reimbursement, coding guidelines, contract terms, and insurance benefits. - Proven leadership experience; with the ability to implement change in a positive, and forward-thinking manner. - Excellent communication (both written and verbal) and problem-solving skills. - Passion for teamwork and continuous improvement. - Ability to operate in high-pressure situations. - Effective organizational, planning, and project management skills. - Skilled in leveraging reporting and data analytics to optimize operations and inform strategic decisions. - Strong EPIC experience navigating orders, clinical documentation and authorization fields preferred. Work Environment & Flexibility Mostly Remote (Monday-Friday; 8am-5pm) for optimal work-life balance Onsite requirements: Monthly for Leadership Retreats to collaborate and plan with colleagues within Rev Cycle, and Quarterly onsite meetings with FC team required at CHOP- to inspire teamwork by bringing the group together to plan boldly, connect meaningfully, and innovate for lasting impact. Ready to grow with us? Apply today and help shape the future of Financial Clearance at CHOP! What you will do - Acts as internal expert on the use, interpretation and accurate application of Epic Tool as used for developing patient cost estimates. - Develops methods to maintain or improve Financial Clearance team performance in accordance with organizational standards. - Develops, monitors, and assesses business metrics in order to refine processes and improve efficiencies. - Contributes to optimum performance through management, oversight, and continuous improvement of the daily operations to achieve key performance targets. - Supervisor must anticipate and respond effectively to evolving market and environmental trends, (e.g., shifts in payment models, value based purchasing, transparency of outcomes and information technology). - Assists in revenue maximization through ensuring quality and standardization in both the front-end and back-end processes related to patient cost estimates. - Establishes positive and highly communicative relationships with all leadership personnel, with the intent purpose of serving as a liaison, providing an unbiased perspective in identification of workflow challenges and solution process. - Influence a family's decision to choose CHOP as their child's care provider through educated, informed, and accurate patient cost estimates tied to CHOP quality and value. - Supervises operational staff responsible for financial clearance spanning authorizations to patient estimations: - Handles staff feedback regarding job performance. - Meets with each staff member 'one-on-one' regularly. - Conducts monthly department staff meetings and in-services as needed. - Completes all written performance appraisals in a comprehensive and timely manner. - Identifies potential deficiencies and works in a proactive approach to resolve issues. - Completes any performance improvement plans necessary for staff development. - Recognize excellent achievements among staff. - Routinely communicates the department's performance with staff and solicits their feedback regarding workflow and enhancements to the estimation process. - Ensures timely completion of authorizations in accordance with the payer's policies and contract guidelines. Ensures accounts are updated appropriately. - Ensures adequate staff coverage for Precert Team; coordinates work load with time off requests - Replies to inquiries for financial clearance support, price estimates and ensures that accurate preparation of estimates based on anticipated services and type of estimate requested (i.e. charges, reimbursement, patient responsibility, etc.) - Remains updated on network and contract rates regularly, reports changes to management and applicable staff. - Establishes written policies and procedures governing operational workflow. - Obtains denial information relevant to the appeals process and lead necessary action to complete appeals process. - Maintains sound working knowledge of current industry best practice concepts and practices, and is responsible for the integration and adoption of best practice processes. - Proactively identifies and resolves operational and system problems or issues. - Recommends enhancements to the current workflow that will help to streamline the operation and provide greater service at a lower cost. - Partners with Epic teams to identify system delays and partners for system updates. - Accepts payments made in advance of service and hands off to appropriate billing office for posting to patient account. - Ensures all activities are documented within Epic. Education Qualifications - High School Diploma / GED Required - Bachelor's Degree Preferred Experience Qualifications - At least five (5) years experience in Financial Counseling, Revenue Cycle or Operations Required - Supervisory experience Preferred Skills and Abilities - Strong teamwork skills - Excellent organizational, project management, interpersonal, leadership and customer service skills - Displays in-depth understanding of contracting terms, including managed care business processes, enrollment, and benefit design. - Experience with Medical Billing and Reimbursement preferred. - Experience in a healthcare setting in a customer facing environment, preferred. - Demonstrates excellence in utilization of CHOP EHR. - Working knowledge of coding rules required preferred. Licenses and Certifications - Certified Revenue Cycle Representative (CRCR) - Healthcare Financial Management Association - - Preferred - EPIC certification - Trainer Certification - - Preferred To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must receive an annual influenza vaccine. Learn more. EEO / VEVRAA Federal Contractor | Tobacco Statement SALARY RANGE: $83,700.00 - $106,700.00 Annually Salary ranges are shown for full-time jobs. If you're working part-time, your pay will be adjusted accordingly. - ------------------ This job is eligible for an incentive program. At CHOP, we are committed to fair and transparent pay practices. Factors such as skills and experience could result in an offer above the salary range noted in this job posting. 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