Director Pre-Services

UNC Health; North Carolina; Remote; USD 124,000 - 178,000; Full time

Job summary

UNC Health is seeking an executive to oversee revenue cycle pre-service operations across the Health Care System, guiding strategic planning, budgeting, and performance improvement to optimize reimbursement for hospital and physician services.

The role directs insurance verification, patient estimates, price transparency, and denial management, while building data-driven staffing and metrics to support organizational goals and patient satisfaction.

Qualifications

• Seven (7) years of experience in the healthcare industry performing duties related to pre-services.
• Five (5) years of supervisory experience in a pre-services management function.
• Understands and appropriately applies principles, procedures, requirements, regulations, and policies related to specialized expertise.
• Excellent verbal and written communication and high level of interpersonal skills.

Responsibilities

• Pre-Services: Directs all pre-services functions including insurance verification, pre-registration, patient estimates, price transparency call center, billing, edits, denials, quality audits, and training.
• Create data-supported staffing models to effectively balance quality data capture and reduce back-end denials and revenue loss.
• Strategic Planning: Analyze planned and sentinel events to develop strategies for improvement.
• Metric Management/Performance Improvement: Develop, monitor, and report metrics; set goals and objectives.
• Operations: Collaborate among entities and departments; prepare and report operational data.
• Budget: Prepare and defend capital and operational budgets; monitor budgetary trends and communicate variances.

Skills

Verbal and written communication

Interpersonal skills

Education

Bachelor’s degree in Finance, Business, Hospital Administration, or related field

Job description

Description

Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.

Description

Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.

Summary

This position is responsible for the overall management of revenue cycle pre-service operations for the Health Care System, including strategic planning, capital and operational budgeting, financial analysis, key metric development and management, regulatory compliance, problem resolution, personnel management, and performance improvement. Pre-Service operations may include, but are not limited to pre-registration, insurance verification, patient estimates, price transparency, billing, pre and post claim edits, and denials for hospital and physician services.

Responsibilities

• Pre-Services: Responsible for directing all pre-services functions including insurance verification, pre-registration, patient estimates, price transparency call center, billing, edits, denials, quality audits, and training. Plans for system changes to improve financial performance. Identifies and implements systems that prevent revenue loss, ensure correct reimbursement for services, and encourage timely receipts. Contributes to collaboration, integration, and performance improvement activities with revenue cycle and clinical operations managers to achieve strategic, financial, and operational performance goals.
• Human Resources: Selects, trains, evaluates, and counsels' management personnel fostering a positive, supportive culture that minimizes employee turnover. Dynamic interpretation and application of rules and regulations relative to revenue cycle functions for designated operational areas. Create and maintain work plans providing timely and relevant feedback to supervisors and subordinate employees. Provides guidance and direction to employees in complex cases. Communicates effectively with internal and external customers and employs methods to promote employee satisfaction. Create data-supported staffing models to effectively balance quality data capture and reduce back-end denials and revenue loss.
• Strategic Planning: Analyze planned and sentinel events to develop strategies for improvement. Routinely evaluate industry and market forces to provide recommendations for new and/or evolving business development and/or improvement in efficiency and effectiveness of operations.
• Metric Management/Performance Improvement: Develop, monitor, and report metrics. Set goals and objectives. Develop and implement processes and procedures to reach and exceed goals.
• Operations: Actively participate and collaborate among entities and departments promoting performance improvement and patient satisfaction. Prioritize and communicate initiatives. Maintain subject matter expertise in all information systems necessary to lead, implement, and support business processes. Prepare and report operational data.
• Budget: Preparation and defense of capital and operational budgets. Adherence with approved budget. Monitor and analyze budgetary trends to make necessary adjustments to ensure budget projections are met. Proactive communication of unintended variances with plans for mitigation.

Other Information

Other information:

Education Requirements

• Bachelor’s degree in Finance, Business, Hospital Administration, or related field.

Licensure/Certification Requirements

• No licensure or certification required.

Professional Experience Requirements

• Seven (7) years of experience in the healthcare industry performing duties related to pre-services, including five (5) years of supervisory experience in a pre-services management function.

Knowledge/Skills/and Abilities Requirements

• Understands and appropriately applies principles, procedures, requirements, regulations, and policies related to specialized expertise. Excellent verbal and written communication and high level of interpersonal skills.

Job Details

Legal Employer: NCHEALTH
Entity: Shared Services
Organization Unit: Pre-Arrival Unit
Work Type: Full Time
Standard Hours Per Week: 40.00
Salary Range: $59.51 - $85.54 per hour (Hiring Range)
Pay offers are determined by experience and internal equity
Work Assignment Type: Remote
Work Schedule: Day Job
Location of Job: US:NC:Chapel Hill
Exempt From Overtime: Exempt: Yes
This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.
Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities.