Patient Financial Services Manager

Position Summary

Patient Financial Services Manager oversees all front- and back-end revenue cycle functions related to patient billing, collections, insurance follow-up, and financial counseling. This role ensures timely, accurate reimbursement while maintaining a positive patient financial experience and compliance with all regulatory requirements.

Key Responsibilities

• Medicaid Operations: Manage daily operations of Patient Financial Services, including billing, collections, cash posting, credit balances, and account resolution. Monitor accounts receivable, denial trends, and collection performance to ensure optimal cash flow. Develop and implement workflows to improve efficiency, accuracy, and turnaround time. Manage daily Medicaid eligibility, enrollment, redeterminations, and billing processes. Ensure timely and accurate submission of Medicaid claims, adjustments, and appeals. Monitor Medicaid denials and reimbursement trends; implement corrective actions. Stay current on state and federal Medicaid policy changes and ensure operational compliance.

• Leadership & Staff Management: Lead, train, and evaluate PFS staff, including supervisors and team leads. Set performance goals and hold staff accountable to productivity and quality metrics. Foster a culture of accountability, collaboration, and patient-centered service.

• Patient Advocacy & Financial Assistance: Oversee financial assistance, charity care and presumptive eligibility programs. Ensure charity care policies align with federal, state, and organizational requirements (including 501(r), where applicable). Review and approve charity care determinations and complex cases. Ensure compassionate, clear communication with patients regarding financial assistance options. Oversee financial counseling, charity care, and presumptive eligibility processes. Ensure patient-centered communication for vulnerable and underserved populations. Resolve escalated patient and payer issues related to Medicaid coverage.

• Compliance & Audit Support: Maintain compliance with Medicaid regulations and internal financial assistance policies. Support internal and external audits related to Medicaid and charity care. Ensure accurate documentation and internal controls.

• Reporting & Performance Improvement: Prepare reports on Medicaid A/R, eligibility conversion rates, denial trends, and charity care utilization. Identify process improvements to reduce A/R days and improve eligibility capture. Collaborate with registration, case management, clinical, and compliance teams.

Qualifications

• Education: Bachelors degree in Healthcare Administration, Business, Finance, or related field. Master’s degree preferred.

• Experience: 2+ years of patient financial services or revenue cycle experience. Strong background in Medicaid eligibility and billing. Experience in managing charity care or financial assistance programs. Supervisory or management experience required.

Benefits

• Paid Sick Time - effective 90 days after employment

• Paid Vacation Time - effective 90 days after employment

• Health, vision & dental benefits - eligible at 30 days, following the 1st of the following month

• Short and long-term disability and basic life insurance - after 30 days of employment