Director, Patient Financial Services (PFS) - Healthcare CBO

About the role

The Patient Financial Services Director (Hospital Revenue Cycle) is responsible for the overall management of the Hospital Client PFS department operations, including patient accounting, credit and collections, denial management, and other related key revenue cycle activities.

Responsibilities

• Define and achieve departmental objectives
• Manage billing and follow-up of patient accounts
• Comply with third party payer regulations
• Work with company resources to assure ongoing improvements to key revenue cycle indicators
• Leverage extensive experience with healthcare hospital billing systems including electronic claims and authorizations, to maximize revenue and cash flows
• Leverage extensive knowledge of front and back end billing operations
• Demonstrate knowledge of billing and coding regulations
• Demonstrate proficiency with registration, eligibility, and third party verification, billing and collections
• Extensive experience with healthcare hospital billing systems including electronic claims and authorizations, to maximize revenue and cash flows
• Comprehensive knowledge of healthcare, billing, finance and accounting principles
• Detailed knowledge and understanding of billing technical elements, such as standard forms and data, coordination of benefits, third party liability, billing and collection
• Comprehensive knowledge of HFMA MAP metrics
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management
• Identify and address issues, trends, and opportunities
• Prioritize and manage numerous tasks simultaneously
• Establish and develop collaborative relationships with other leaders in the Revenue Cycle
• Work with Managed Care Department for Underpayment Analysis
• Attend and participate in committees and task forces as assigned
• Prepare materials for and conduct project meetings
• Maintain current knowledge of regulatory standards, which may impact utilization of processes and systems
• Seek out opportunities for individual growth and development
• Serve on department and/or institutional committees as requested
• Leverage extensive experience with healthcare hospital billing systems including electronic claims and authorizations, to maximize revenue and cash flows
• Collaborate, mediate, and resolve applicable items/issues between Finance and Hospital PFS
• Possess skills in understanding financial systems and patient accounts and ability to detect and resolve problems related to Accounts Receivable
• Ensure compliance with relevant regulations and standards pertaining to Hospital PFS
• Demonstrate an ability to plan, coordinate, implement and control Hospital Billing and Collection services and to function effectively in a management position in a complex centralized environment
• Leverage extensive knowledge of front and back end billing operations
• Demonstrate knowledge of billing and coding regulations
• Demonstrate proficiency with registration, eligibility, and third party verification, billing and collections
• Extensive experience with healthcare hospital billing systems including electronic claims and authorizations, to maximize revenue and cash flows
• Perform all other job functions related to this job
• Staff hire, review, discipline and separate employment
• Monitor and report daily/monthly productivity
• Ensure Team Member compliance with company policies and procedures
• Verify and monitor time off requests
• Able to fill in for Managers

Requirements

• Requires a Bachelor's Degree and a minimum 12 years of prior relevant experience or Associate's Degree and a minimum 14 years of prior relevant experience.
• (Relevant experience may be substituted for formal education or advanced degree)
• (Relevant experience coming from a healthcare provider, payor, CBO, business office environment or an outsourcing company)

What would be nice to have

• Understanding of healthcare revenue cycle, payer contracts and regulation affecting reimbursement for healthcare services
• Excellent verbal, written, analytical and interpersonal skills
• Ability to handle multiple concurrent activities and change

Pay

The annual salary range for this position is $130,000.00-$216,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

Benefits

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program