Manager of Patient Access - Enterprise Authorizations

Inova Health is seeking a talented and experienced professional to lead our Patient Access team in the System Office Administration - Rev Cycle Insurance Verification department. This role is critical in driving automation, enhancing productivity, and reducing days out in authorizations. The successful candidate will have a proven track record in healthcare operations and a passion for process improvement. This role will be full-time day shift from Monday - Friday, 8:00-5:00pm. (Remote)

The Manager of Patient Access - Enterprise Authorizations (Imaging & Specialty Services) is a strategic leadership role responsible for optimizing enterprise authorization workflows, with a focus on imaging, specialty services, and other complex service lines. This role drives operational efficiency by leveraging automation, reducing administrative burden, and enhancing authorization accuracy in high-volume environments. The manager analyzes trends in denials and performance to identify improvement opportunities, leads process optimization initiatives, and ensures successful implementation of workflow enhancements. Additionally, this leader fosters a culture of accountability and continuous improvement, guiding teams through change management to support evolving organizational and regulatory demands.

Remote Eligibility: This position is eligible for remote work for candidates residing in the following states - VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN, TX, WV

Featured Benefits:

• Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
• Retirement: Inova matches the first 5% of eligible contributions - starting on your first day.
• Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
• Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.

• Work/Life Balance: offering paid time off, paid parental leave, and flexible work schedules

Manager of Patient Access - Enterprise Authorizations Job Responsibilities:

• Creates and enforces work standards, quality measures, and process improvements that are consistent with the organization's goals and objectives. Ensures regulatory compliance with Medicare and state authorities, Generally Accepted Accounting Principles and any external governing authority.
• Assures claims are reviewed, corrections are identified/made or resolutions are initiated while ensuring all follow-up claims/actions are submitted via the appropriate medium and with all required attachments.
• Maintains knowledge of government regulations, payer requirements, UB-04 standards, information system functionality (i.e. Hospital, clearinghouse, payer), hospital policies/procedures and departmental SRGs.
• Evaluates the impact of new or upgrades to existing systems/tools while performing testing of system changes, providing technical/operational support during implementation and evaluating the success of new systems/tools.
• Ensures timely/accurate billing, collection, posting, servicing, and/or auditing of the $1.5 billion receivable stream.
• Ensures follow-up is completed utilizing TRAC work lists, QMS, or other systems/reports according to department policy/procedure, SRG, or industry best practice standards.
• Demonstrates a working knowledge of CareMedic systems, DSS electronic billing systems, Syntellect IVR systems, HealthQuest 2000, QMS, and Premis electronic billing systems.
• Provides feedback and training to supervisors and staff. Provides resolution for pended (WIP backlog) claims within allowable timeframes (as defined for appropriate deficiency) and/or ensures billed claims receive timely and appropriate follow up based on established protocol or SRG.
• Oversees assigned department or functional area to ensure it is performing effectively, which may include but not limited to, hiring and training team members, creating and implementing business strategies, managing performance of team members, and delegating tasks.

Minimum Qualifications:

Experience - Four years of experience in Revenue Cycle, Clinic Operations, Credentialing, Denials Management and/or HB/PB Operation roles; Two years in leadership roles

Education - Bachelors Degree or lesser educational degree with four additional years of experience

Preferred Qualifications:

Experience in healthcare patient access, authorizations, or revenue cycle operations, preferably within a large or complex health system

Project management experience, including leading process improvements, system implementations, or crossfunctional initiatives

Strong strategic and operational focus, with the ability to align team performance to enterprise goals

Prior people management experience, including coaching, performance management, and workforce planning

Working knowledge of payer requirements, authorization workflows, and regulatory compliance (Medicare, Medicaid, commercial payers)

Experience utilizing healthcare systems and performance metrics to drive operational efficiency and outcomes