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Director, Pre-Service Revenue Cycle

Nemours Logo

87610 - 127056 USD


Jacksonville, FL

R. Lawrence Moss, MD

$1 to $5 billion (USD)

Nonprofit Organization



Published 2 days ago

The Director of Pre-Service Revenue Cycle is responsible for overseeing various revenue cycle operations functions including authorization, financial services and estimation.

The Director leads a team of Pre Service Revenue Cycle Specialists that are rooted in the business aspects of hospital care and are accountable for supporting front end revenue cycle performance for the Delaware Valley. The position is not limited to a narrow scope of supporting singular accounting units or teams. The Pre Service teams collaborate across functions, roles, and departments to work toward common goal of margin improvement, holding themselves accountable for this result.

The Director supports managers of Patient Cost Estimation, Financial Advocates, Hospital Preauthorization, and Physician Referral and Authorization. Patient Cost Estimation specialists ensure Nemours remains compliant with all federal regulations specific to the No Surprises Act of 2020, along with Nemours processes related to price estimation. This team is responsible for providing high-level customer service to deliver accurate estimates of a patient's financial responsibility. The Physician Authorization department is responsible for obtaining authorizations for scheduled provider visits, "add on" visits, tests and procedures in a timely manner and following department and industry best practices. The Hospital Preauthorization department is responsible for the authorization process for Urgent and Elective Admissions; Outpatient Surgery; Transports; therapy appointments, Transplants; and multiple hospital-based outpatient departments. The Financial Advocate team supports Medicaid Enrollment, Payment Plans and Cash Services at Nemours.

  • Business management experience required in similar position and/or proven track record of success with similar job functions required in this role.
  • Must have working knowledge of revenue cycle, billing, and regulatory compliance related to the No Surprises Act.
  • Must have knowledge of healthcare operations finance, planning, and budgeting.
  • Master's level preparation preferred; Bachelor's required
  • Certified Healthcare Financial Professional (HFMA)
  • A minimum of 5 years relevant experience

Essential Functions
  • Teach, coach, and mentor team members to develop and grow in their roles, driving high levels of engagement among the team.
  • Build and maintain effective enterprise-wide relationships with key cross-functional leaders and project team members, including clinical and business operations, the VBSO, Continuous Improvement Resource Office, Project management, the Central Business Office, IS, Corporate Accounting, and other Corporate Services departments, etc.
  • Use quantitative and qualitative data that support department performance and drive improvements.
  • Support enterprise and regional strategic initiatives as needed.
  • Serve as a liaison with partners at other locations and across departments, relating to the No Surprises Act or financial innovation related investigations.
  • Provide daily operational management and leadership for teams.
  • Ensure efficient and effective preservice functions to drive improved margin.
  • Foster an environment that supports and respects diversity

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