Director, Patient Financial Services (PFS) - Healthcare CBO

Guidehouse•El Segundo, CA

8d•$130,000 - $216,000

About The Position

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.

Requirements

extensive experience with healthcare hospital billing systems including electronic claims and authorizations, to maximize revenue and cash flows
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
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
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

Nice To Haves

Understanding of healthcare revenue cycle, payer contracts and regulation affecting reimbursement for healthcare services
Excellent verbal, written, analytical and interpersonal skills
Ability to handle multiple concurrent activities and change

Responsibilities

overall management of the Hospital Client PFS department operations, including patient accounting, credit and collections, denial management, and other related key revenue cycle activities
define and achieve departmental objectives
manage billing and follow-up of patient accounts
compliance with third party payer regulations
work with company resources to assure ongoing improvements to key revenue cycle indicators
maximize revenue and cash flows
review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management
research 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
prioritize and manage numerous tasks simultaneously
establish and develop collaborative relationships with other leaders in the Revenue Cycle
work with Managed Care Department for Underpayment Analysis
attend and participate in committees and task forces as assigned
prepare materials for and with experience conducts and chairs project meetings
maintain current knowledge of regulatory standards, which may impact utilization of processes and systems
seek out opportunities for individual growth and development, including attending various meetings, conferences, and courses, as required
participate in the development of PFS policies and procedures
serve on department and/or institutional committees as requested
collaborate, mediate, and resolve applicable items/issues between Finance and Hospital PFS
detect and resolve problems related to Accounts Receivable
ensure compliance with relevant regulations and standards pertaining to Hospital PFS
plan, coordinate, implement and control Hospital Billing and Collection services and to function effectively in a management position in a complex centralized environment
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

Benefits

Medical, Rx, Dental & Vision Insurance
Personal and Family Sick Time & Company Paid Holidays
Position may be eligible for a discretionary variable incentive bonus
Parental Leave
401(k) Retirement Plan
Basic Life & Supplemental Life
Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
Short-Term & Long-Term Disability
Tuition Reimbursement, Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Emergency Back-Up Childcare Program