Job Description
Job Family PFS General Travel Required Up to 10% Clearance Required None What You Will Do 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. The Director will define and achieve departmental objectives, manage billing and follow-up of patient accounts, compliance with third party payer regulations, and 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 Ability to review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management. Upon identification of issues, researches issue to determine whether it is an isolated instance or a trend and follows up the appropriate Revenue Cycle leadership to facilitate communication and resolution of the issues. Ability to successfully prioritize and manage numerous tasks simultaneously. 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, which may impact utilization of processes and systems. Seeks out opportunities for individual growth and development, including attending various meetings, conferences, and courses, as required. Participates in the development of PFS policies and procedures. Serves 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 order to understand 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. Demonstrates 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. 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. What You Will Need 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