SENIOR DIRECTOR PATIENT FINANCIAL SERVICES

About the role

The Senior Director of Patient Financial Services is expected to demonstrate, through plans and actions, a consistent standard of excellence to which all departmental work is expected to conform. This role focuses on continuous improvement within the Director's area of influence and delivering the highest degree of quality service possible. Critical responsibilities include achieving annual and periodic goals for key statistical indicators for CMG’s revenue cycle and patient account performance.

The Director leads the organizational effort to optimize performance across all components of patient access, scheduling, claims management, and professional code auditing in all aligned medical practices. This includes managing all elements of the patient encounter, billing and collection cycle, compliance, software utilization, and associated outside vendors. The Revenue Cycle Director identifies opportunities for improvement and manages the implementation of solutions.

Responsibilities

• Complete various financial forecasts, including long-range strategic plans for the department.
• Maintain appropriate internal control safeguards over accounts receivable (AR) records and cash collection.
• Direct insurance processors and customer service representatives in daily operational tasks.
• Ensure claims denials and rejections are logged for measurement and analysis.
• Ensure compliance with relevant regulations, standards, and directives.
• Review and understand regulatory billing updates.
• Chart process workflow.
• Play an integral role in the implementation and installation of new systems and related processes.
• Complete random account audits weekly to identify opportunities for improvement.
• Collaborate with patient access to improve accounts receivable performance.
• Address medical necessity denials, authorization denials, and accuracy of demographic and insurance information.
• Audit clinical documentation for CPT/HCPCS coding.
• Ensure accuracy of ICD-10 in the practice setting.
• Manage the claims appeal process.
• Maintain efficient and effective workflow in the central billing office and revenue cycle components of all medical practice sites.
• Interpret complex contractual arrangements.
• Optimize revenue of managed care within varied contract structures.
• Analyze data, determine trends, utilize statistical principles, and convey financial projections for CMG.
• Develop the annual budget for the central billing office and contribute to the development of the annual budget for each practice site and the Medical Group.
• Monitor budget variance for the central billing office.
• Work with Finance to assure accurate and timely reconciliation of all monies.
• Perform other duties as assigned or requested, with job specifications subject to modification.

Qualifications

• Required Education: Bachelor’s Degree or, in lieu of a degree, a minimum of ten (10) years of healthcare revenue cycle experience.
• Preferred Education: Master’s Degree.
• Required Experience:
  • Thorough understanding of coding methods, including CPT, ICD, and HCPCS.
  • Able to work in a complex and changing environment.
  • Three or more (3+) years of medical billing experience.
  • Five or more (5+) years in a professional medical services area such as a medical office or outpatient department.
  • Three or more (3+) years of experience managing staff.

Pay

$141,220 - $225,952