Director, Patient Financial Services (PFS) - Healthcare CBO

Guidehouse•San Antonio, TX

14d•$106,000 - $176,000•Onsite

About The Position

The Patient Financial Services Director is responsible for the overall management of Hospital Client PFS department operations, including patient accounting, credit and collections, denial management, and other key revenue cycle activities. The Director defines and achieves departmental objectives, manages patient-account billing and follow-up, ensures compliance with third-party payer regulations, and works with company resources to improve revenue cycle indicators. The role involves maximizing revenue and cash flows through extensive knowledge of hospital billing systems, electronic claims and authorizations, and front- and back-end billing operations. The Director analyzes operational data, identifies issues and trends, researches whether problems are isolated or systemic, and coordinates communication and resolution with Revenue Cycle leadership. The role collaborates with other Revenue Cycle leaders and Finance, works with Managed Care on underpayment analysis, participates in committees and task forces, and develops PFS policies and procedures. It also includes planning, coordinating, implementing, and controlling Hospital Billing and Collection services in a complex centralized environment while maintaining knowledge of regulatory requirements. Staff responsibilities include hiring, reviewing, disciplining, and separating employees; monitoring and reporting productivity; ensuring team compliance with company policies; managing time-off requests; and filling in for managers. The role is preferred to be based onsite in the San Antonio office, but candidates outside San Antonio are also considered.

Requirements

Bachelor's degree and a minimum of 12 years of relevant experience, or an associate degree and a minimum of 14 years of relevant experience; relevant experience may be substituted for formal education or an advanced degree.
Relevant experience in a healthcare provider, payer, CBO, business office environment, or outsourcing company.
Experience in accounts receivable follow-up, denials management, and driving client engagement.
Extensive knowledge of healthcare hospital billing systems, including electronic claims and authorizations.
Knowledge of front- and back-end billing operations and billing and coding regulations.
Proficiency with registration, eligibility, third-party verification, billing, and collections.
Comprehensive knowledge of healthcare, billing, finance, and accounting principles.
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 analyze data and identify operational impacts, issues, trends, and opportunities.
Ability to prioritize and manage numerous tasks simultaneously.
Ability to understand financial systems and patient accounts and detect and resolve accounts receivable problems.
Ability to plan, coordinate, implement, and control Hospital Billing and Collection services in a complex centralized environment.

Nice To Haves

Located in San Antonio or willing to relocate.
Understanding of healthcare revenue cycle, payer contracts, and regulations affecting reimbursement for healthcare services.
Excellent verbal, written, analytical, and interpersonal skills.
Ability to handle multiple concurrent activities and change.

Responsibilities

Manage Hospital Client PFS department operations, including patient accounting, credit and collections, denial management, and other 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 Hospital PFS standards.
Use healthcare hospital billing systems, electronic claims, and authorizations to maximize revenue and cash flows.
Review data to determine operational impacts and required actions; elevate issues, trends, improvement areas, and opportunities to management.
Research identified issues to determine whether they are isolated or represent trends, and coordinate communication and resolution with Revenue Cycle leadership.
Establish and develop collaborative relationships with other Revenue Cycle leaders.
Work with the Managed Care Department on underpayment analysis.
Collaborate, mediate, and resolve applicable issues between Finance and Hospital PFS.
Attend and participate in assigned committees and task forces; serve on department or institutional committees as requested.
Prepare materials for project meetings and, when experienced, conduct and chair those meetings.
Maintain current knowledge of regulatory standards that may affect processes and systems.
Participate in developing PFS policies and procedures and pursue individual growth and development.
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 members comply with company policies and procedures; verify and monitor time-off requests; and fill in for managers.
Perform other job functions related to the role.

Benefits

Medical, prescription, dental, and vision insurance.
Personal and family sick time and company-paid holidays.
Position may be eligible for a discretionary variable incentive bonus.
Parental leave.
401(k) retirement plan.
Basic life and supplemental life insurance.
Health Savings Account and dental, vision, and dependent care Flexible Spending Accounts.
Short-term and long-term disability.
Tuition reimbursement, personal development, and learning opportunities.
Skills development and certifications.
Employee referral program.
Corporate-sponsored events and community outreach.
Emergency back-up childcare program.