Director, Patient Financial Services (PFS) - Healthcare CBO

Guidehouse•San Antonio, TX

2d•Onsite

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. This role requires extensive experience with healthcare hospital billing systems, electronic claims and authorizations, to maximize revenue and cash flows, as well as comprehensive knowledge of healthcare, billing, finance and accounting principles. The Director will also be responsible for staff management, including hiring, reviewing, disciplining, and separating employment, as well as monitoring and reporting daily/monthly productivity and ensuring team member compliance with company policies and procedures.

Requirements

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.
Work in San Antonio, TX
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.
Knowledge of billing and coding regulations.
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.
Ability to review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
Ability to successfully prioritize and manage numerous tasks simultaneously.
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.

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.
We will consider individuals open to relocation to San Antonio!

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.
Ensure compliance with third party payer regulations.
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.
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, research issue to determine whether it is an isolated instance or a trend and follow up with the appropriate Revenue Cycle leadership to facilitate communication and resolution of the issues.
Ability to successfully 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 conduct and chair 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.
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.
Demonstrate 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.
Perform all other job functions related to this job.
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

Competitive compensation
Flexible benefits package
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