Assoc. Director- Patient Financial Services (PFS)- Healthcare CBO

Guidehouse•San Antonio, TX

4d•Onsite

About The Position

The Associate Director of Patient Financial Services (Hospital Revenue Cycle) is responsible for overall management of Hospital Client PFS department operations, including patient accounting, credit and collections, denial management, and related revenue cycle activities. The role defines and achieves departmental objectives, manages billing and follow-up of patient accounts, ensures compliance with third-party payer regulations, and works with company resources to improve key revenue cycle indicators and maximize revenue and cash flows. The position requires broad knowledge of healthcare billing and finance, including front- and back-end billing operations, billing and coding regulations, registration, eligibility, third-party verification, electronic claims and authorizations, accounts receivable follow-up, denials management, and HFMA MAP metrics. The Associate Director reviews operational data, researches issues and trends, escalates findings, and coordinates resolution with Revenue Cycle leadership. The role also collaborates with Finance, Hospital PFS, Managed Care, and other leaders; supports underpayment analysis; participates in committees and task forces; and contributes to PFS policies and procedures. The role includes staff leadership responsibilities such as hiring, reviewing, disciplining, and separating employees; monitoring and reporting productivity; ensuring policy compliance; managing time-off requests; and filling in for managers. The preferred work location is the San Antonio office, though candidates outside San Antonio may also be considered. Travel may be required up to 25%.

Requirements

Bachelor's degree and a minimum of 10 years of prior relevant experience; relevant experience may substitute for formal education or an advanced degree.
Relevant experience in a healthcare provider, payor, CBO, business office environment, or outsourcing company.
Experience in accounts receivable follow-up, denials management, and driving client engagement.
Extensive experience with healthcare hospital billing systems, including electronic claims and authorizations.
Comprehensive knowledge of healthcare, billing, finance, and accounting principles.
Knowledge of front- and back-end billing operations and billing and coding regulations.
Proficiency with registration, eligibility, third-party verification, billing, and collections.
Detailed understanding of billing technical elements, including standard forms and data, coordination of benefits, third-party liability, billing, and collection.
Comprehensive knowledge of HFMA MAP metrics.
Ability to understand financial systems and patient accounts and detect and resolve accounts receivable problems.
Ability to analyze data, prioritize and manage numerous tasks simultaneously, and handle multiple concurrent activities and change.
Ability to plan, coordinate, implement, and control Hospital Billing and Collection services and function effectively in a management position in a complex centralized environment.
Excellent verbal, written, analytical, and interpersonal skills.

Nice To Haves

Preferably located in San Antonio or willing to relocate.
Understanding of healthcare revenue cycle, payer contracts, and regulations affecting reimbursement for healthcare services.

Responsibilities

Manage Hospital Client PFS department operations, including patient accounting, credit and collections, denial management, and related revenue cycle activities.
Define and achieve departmental objectives and manage billing and follow-up of patient accounts.
Ensure compliance with third-party payer regulations and applicable standards affecting Hospital PFS.
Work with company resources to improve key revenue cycle indicators and maximize revenue and cash flows.
Review operational data to determine impacts and required actions; identify and elevate issues, trends, improvement areas, and opportunities to management.
Research identified issues to determine whether they are isolated instances or trends, and work with Revenue Cycle leadership to facilitate communication and resolution.
Establish collaborative relationships with other Revenue Cycle leaders and collaborate to resolve issues between Finance and Hospital PFS.
Work with the Managed Care Department on underpayment analysis.
Attend and participate in assigned committees and task forces; prepare materials for project meetings and conduct or chair meetings as needed.
Maintain current knowledge of regulatory standards that may affect processes and systems.
Participate in developing PFS policies and procedures and serve on department or institutional committees as requested.
Plan, coordinate, implement, and control Hospital Billing and Collection services in a complex centralized environment.
Hire, review, discipline, and separate staff; monitor and report daily and monthly productivity; ensure team member compliance with company policies and procedures; verify and monitor time-off requests; and fill in for managers.
Perform other job functions related to the role.
Seek opportunities for individual growth and development, including meetings, conferences, and courses as required.