Director, Financial Services (Bad Debt & Self Pay Management)

Northwell•Melville, NY

19h

About The Position

The Director, Financial Services is responsible for overseeing the enterprise self-pay receivable, ensuring delivery of exceptional customer service while achieving performance metrics. This role involves planning, staff management and continuous improvement initiatives to enhance operational efficiency and customer satisfaction. The Director partners with various levels of revenue cycle, and cross-functional teams across the health system to ensure operational excellence, with the ability to identify upstream issues impacting patient balances.

Requirements

Bachelor's Degree required, or equivalent combination of education and related experience.
8-12 years of relevant experience and 7+ years of leadership / management experience, required.

Nice To Haves

Prior bad debt and self-pay management experience.
EPIC experience.
Strong understanding of all stages of Revenue Cycle, including registration, billing, and claims processing to ensure self-pay inventory is accurate and appropriate.
Skilled in budgeting, forecasting, and cost management.
Ability to lead through transformation and foster a culture of continuous improvement.
Proficiency in data analysis and quantification includes interpreting statistical data to identify trends and exceptions required.

Responsibilities

Leads a Financial Services group by communicating with and developing staff members, and building consensus for programs and goals that support a business, function or geographic area.
Develops and articulates a short-term strategic vision for areas of responsibility.
Participates in the development of strategic short and long-term plans, policies, procedures and standards to improve operational and financial operations; promotes quality and productivity improvement through development and implementation of improved procedures and processes; collaborates with leadership to identify best practices, deficiencies, and identify opportunities.
Monitors, researches, and keeps abreast of regulatory updates impacting operations; forecasts and plans for ongoing updates to operational policies and procedures.
Manages and ensures timely and accurate resolution of issues regarding outsourcing partners aligned to operations; directs the development and reporting of benchmarks and metrics related to operational efficiencies and turn-around-time.
Plans and monitors department budget; establishes and standardizes financial management system to support financial reporting requirements.
Directs the implementation of Human Resources plans to achieve strategic goals and objectives including organizational development, recruiting, compensation, training and development, employee engagement and relations; selects, develops, manages, and evaluates direct reports; oversees the selection, development, management and evaluation of indirect reports; ensures performance appraisals are completed in a timely manner; manages productivity, resolves issues and prepares analysis to monitor and ensure quality control and performance improvement.
Manages specific to Accounts Receivable operations: Accounts Receivable / escalation of system issues, Payer Compliance (Payer Underpayments), Managed Care Contracting participation Receivables outsourced partners; also manages specific to Cash Management and Enrollment operations: Cash Management / Payment posting, Customer Service, Provider Enrollment, Payment and Enrollment outsourced partners.
Collaborates with management and clinical personnel to ensure resolution of coding and billing issues; manages and ensures timely and accurate resolution of system edits impacting operations from interfaces; attends Chair Committee meetings and maintains open communications and good working relationships with all levels of management; encourages recommendations for improvement and changes from all areas to enhance current operations; develops and pre participates in the implementation of specific software system tools and system upgrades to support billing systems, i.e., payer compliance software, provider enrollment software; sends executive dashboards with explanations on monthly performance against established goals.
Promotes quality and productivity improvements through the development of improved procedures, process innovations and changes which support the strategic direction of the CBO.
Ensures compliance with federal, state, and local regulations and tax laws, and regulatory agency standards of compliance; maintains current knowledge of regulatory guidelines, billing processes, federal, state, and regulatory agency reimbursement changes.
Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.
Formulate and execute the annual Single Business Office (SBO) AR Management business plan, including the development of strategic initiatives and long-term goals for revenue optimization, patient engagement, and operational efficiency
Manage and accelerate resolution of legacy self-pay inventory as we shift to Epic.
Provide comprehensive and continuous review of Bad Debt vendors, processes, regulatory updates, and inventory with a strong understanding of the FDCPA, TCPA, and CFPB.
Champion and drive innovation, evaluating new technologies and process improvements to enhance service delivery, improve efficiency, drive collections and adapt to evolving patient expectations.
Lead systematic and rational analysis to identify root causes of deficiencies within critical workflows, systems, and processes directly impacting self-pay billing operations and the patient financial experience. This includes optimizing processes related to patient financial inquiry resolution, payment arrangement administration, financial counseling workflows, statement clarity, pre-service & estimate financial discussions, and self-service abilities.
Develop, recommend, and implement comprehensive process improvements designed to streamline patient financial interactions, drive significant efficiencies, enhance overall patient financial understanding and satisfaction, and measurably improve self-pay collection rates all while ensuring strict adherence to federal and New York State regulations governing medical billing, collections, and patient financial transparency.
Establish, monitor, and report on key performance indicators (KPIs) and service level agreements (SLAs) to ensure department quality, financial targets, and productivity goals are consistently met or exceeded.
Ensure daily workflows are meticulously maintained to achieve optimal quality, quantity, and efficiency. Proactively monitor and manage self-pay inventory and patient accounts to ensure timely addressal, follow-up, and resolution, minimizing aged receivables.
Conduct in-depth analysis of self-pay metrics, reports, and dashboards to identify trends, anomalies, and areas for improvement. Leverage data to inform strategic decisions, optimize staffing, and enhance operational effectiveness.
Implement and oversee robust quality assurance programs for patient interactions. Ensure strict adherence to all regulatory requirements, HIPAA, PCI compliance, and organizational policies related to patient data privacy and financial transactions.
Proactively identify opportunities where the single business office (SBO) performance impacts other areas of the revenue cycle (e.g., front-end registration, coding, denials management) and collaborate to implement preventative measures or corrective actions.
Conduct routine staff meetings, annual performance evaluations, and provide timely, constructive feedback. Address performance issues and administer counseling or disciplinary action as necessary, adhering to HR policies.