Director, Patient Financial Services (PFS) - Healthcare CBO

About the role

The Patient Financial Services Director (Hospital Revenue Cycle) oversees the operations of the Hospital Client PFS department, focusing on patient accounting, credit and collections, denial management, and other revenue cycle activities. Key responsibilities include defining and achieving departmental objectives, managing billing and follow-up of patient accounts, ensuring compliance with third-party payer regulations, and working with company resources to improve key revenue cycle indicators.

Responsibilities

• Define and achieve departmental objectives
• Manage billing and follow-up of patient accounts
• Ensure compliance with third-party payer regulations
• Work with company resources to improve key revenue cycle indicators
• 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
• Attend and participate in committees and task forces as assigned
• Prepare materials for and conduct project meetings
• Maintain current knowledge of regulatory standards
• Seek out opportunities for individual growth and development
• Develop and implement PFS policies and procedures
• Collaborate with Managed Care Department for Underpayment Analysis
• Ensure compliance with relevant regulations and standards pertaining to Hospital PFS
• Plan, coordinate, implement, and control Hospital Billing and Collection services
• Function effectively in a management position in a complex centralized environment
• Understand financial systems and patient accounts and ability to detect and resolve problems related to Accounts Receivable
• 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)
• Work in San Antonio, TX
• We will consider individuals open to relocation to San Antonio!

Qualifications

• 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

Skills

• 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
• Establishes and develops collaborative relationships with other leaders in the Revenue Cycle
• Works with Managed Care Department for Underpayment Analysis
• Attends and participates in committees and task forces as assigned
• Prepares materials for and with experience conducts and chairs project meetings
• Maintains current knowledge of regulatory standards
• Serves on department and/or institutional committees as requested
• Performs 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