Manager, Patient Financial Services - Hospital Revenue Cycle

Guidehouse•San Marcos, CA

12d•Onsite

About The Position

The Patient Financial Services Manager – Hospital Revenue Cycle supervises PFS staff and oversees daily billing, cash posting, and collections operations. This is a full-time, onsite position at the San Marcos, California business office, working Monday through Friday. The manager leads staff, supports training and communication, maintains compliance, and monitors departmental performance, productivity, and revenue-cycle goals. The role drives cash collection and accounts receivable resolution, works with payers and internal departments to address billing and reimbursement issues, and oversees third-party and self-pay account follow-up. It manages reporting, Medicare bad-debt documentation and vendor reconciliation, and projects to reduce aged accounts receivable and improve collections. The manager also communicates compliance requirements, maintains billing-related accreditation requirements, and ensures accounts and reports are properly documented and completed on time.

Requirements

Bachelor’s degree and at least 7 years of prior relevant experience, or an associate degree and at least 9 years of prior relevant experience; relevant experience may substitute for formal education or an advanced degree.
At least 2 years of people management experience within the required relevant experience.
Relevant experience in healthcare, business, or professional settings.
Strong accounts receivable acumen and ability to exercise sound judgment and make quick decisions.
Experience driving cash collection and accounts receivable resolution.
Ability to work with payers on issue resolution and escalation.
Ability to manage billing, cash posting, collections, reimbursement variances, and account follow-up.
Ability to communicate compliance requirements and ensure staff understand applicable procedures.

Nice To Haves

Solid understanding of the healthcare revenue cycle.
Demonstrated ability to work effectively in teams and communicate with all levels.

Responsibilities

Supervise PFS staff in daily billing, cash posting, collections, and account follow-up operations.
Lead and support staff through fair, consistent management; promote teamwork, trust, open communication, employee input, and training.
Ensure employees understand applicable state and federal rules, regulations, compliance requirements, and reporting procedures.
Drive cash collection and accounts receivable resolution, working with payers to resolve and escalate issues.
Manage expected reimbursement variances and coordinate with departments to ensure accurate CPT4, HCPCS, and revenue codes.
Provide departments with Medicare and other payer updates, notices, and coverage changes affecting billing and reimbursement.
Review processes and systems to maintain effective methods and meet departmental and facility goals; coordinate billing-related changes with IT.
Ensure electronic bill holds meet established goals and work with electronic billing vendors and payers to resolve billing and cash-posting issues.
Identify and resolve patient accounts receivable process problems, and initiate changes when appropriate to address payer issues, underpayments, and denials.
Review and approve account credit arrangements, refunds, write-offs, and adjustments while ensuring compliance with signature-level policies.
Manage employee follow-up on third-party and self-pay accounts after initial billing.
Prepare, distribute, and present daily, weekly, and monthly reporting packages; monitor departmental performance and productivity and ensure reports are completed on time.
Serve as a technical resource for Medicare regulations and reimbursement; ensure Medicare Bad Debt Log components and supporting documentation are complete and oversee bad-debt vendor reconciliation.
Communicate compliance issues to management and educate staff on compliance and appropriate reporting procedures.
Attend relevant internal and external seminars and share information with staff and other departments.
Review and maintain JACHO requirements for billing, cash posting, and collections.
Complete assigned projects within given time frames, document worked accounts in the patient accounting system, and ensure established goals are met.
Develop and execute projects to reduce aged accounts receivable and enhance collections.
Manage client service-level metrics and revenue-cycle performance indicators, and develop and follow methods for KPI improvement.
Prepare weekly Key Indicator Reports, provide Patient Accounting and Billing Scrubber reports to departments daily, maintain departmental claim-hold logs, and prepare daily electronic and paper claim reports and other requested reports.