New

Director of Surgery and Admissions Prior Authorization

Mass General Brigham (Enterprise Services)
United States, Massachusetts, Somerville
399 Revolution Drive (Show on map)
Sep 09, 2025
Responsible for overseeing the financial clearance operations to ensure patient eligibility, benefits verification, and authorization processes are accurately managed. Ensures efficient and compliant financial clearance workflows that support revenue cycle goals and improve the patient experience Does this position require Patient Care? No Essential Functions Leads financial clearance operations, including eligibility verification, benefits coordination, and prior authorization processes. -Collaborates with patient access, billing, and managed care teams to optimize workflows and reduce delays. -Develops and implements policies to ensure compliance with regulatory requirements and payer guidelines. -Monitors financial clearance performance metrics, identifying and addressing areas for improvement. -Manages relationships with payers and other stakeholders to resolve issues related to coverage and authorizations. -Oversees the training and development of financial clearance staff, fostering a knowledgeable and service-oriented team. -Analyzes trends in denials and authorizations, developing strategies to minimize financial risk. -Prepares reports for senior leadership on financial clearance activities and performance. -Ensures the accuracy and efficiency of data collection and documentation for patient financial records. Education Bachelor's Degree Healthcare Administration required or Bachelor's Degree Business required or Bachelor's Degree Finance required or Bachelor's Degree Related Field of Study required or Master's Degree Related Field of Study preferred Can this role accept experience in lieu of a degree? No Licenses and Credentials Experience Experience in financial clearance, revenue cycle management, contract management, or other closely related role, preferably in a managed care setting 8-10+ years required and Experience in a management or leadership role 5-7 years required Knowledge, Skills and Abilities - Strong understanding of payer regulations, authorizations, and managed care requirements. - Proficiency in healthcare revenue cycle processes and systems. - Analytical skills to assess financial data and operational metrics. - Effective communication and collaboration skills to work with cross-functional teams and external partners. - Leadership abilities for team management and staff development. Physical Requirements Standing Frequently (34-66%) Walking Frequently (34-66%) Sitting Occasionally (3-33%) Lifting Occasionally (3-33%) 35lbs+ (w/assisted device) Carrying Occasionally (3-33%) 35lbs+ (w/assisted device) Pushing Occasionally (3-33%) Pulling Occasionally (3-33%) Climbing Occasionally (3-33%) Balancing Frequently (34-66%) Stooping Occasionally (3-33%) Kneeling Occasionally (3-33%) Crouching Occasionally (3-33%) Crawling Occasionally (3-33%) Reaching Occasionally (3-33%) Gross Manipulation (Handling) Frequently (34-66%) Fine Manipulation (Fingering) Frequently (34-66%) Feeling Constantly (67-100%) Foot Use Rarely (Less than 2%) Vision - Far Constantly (67-100%) Vision - Near Constantly (67-100%) Talking Constantly (67-100%) Hearing Constantly (67-100%) Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.