Manager, Patient Financial Services - Hospital Revenue Cycle
About The Position
The Patient Financial Services Manager – Hospital Revenue Cycle supervises PFS staff and daily billing, cash-posting, and collections operations. The role leads staff fairly and consistently, supports a productive and communicative working environment, and ensures employees have the tools, training, and knowledge needed to meet departmental and facility goals. The manager also works across departments, with payers and vendors, and with IT to resolve revenue-cycle issues, maintain accurate billing, and improve cash and accounts-receivable outcomes. The position oversees compliance with applicable State and Federal rules, regulations, HIPAA, and billing-related JACHO requirements. It monitors performance and productivity, manages reporting and key indicators, oversees Medicare bad-debt documentation and vendor reconciliation, and keeps management informed of compliance issues. Assigned projects must be completed within established time frames. This is a full-time, onsite position in the San Marcos, California business office, working Monday through Friday. Travel required is up to 10%.
Requirements
- A 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.
- Relevant experience in healthcare, business, or professional settings.
- At least 2 years of people-management experience within the required relevant experience.
- Ability to exercise sound judgment and make quick decisions, with strong accounts-receivable acumen.
Nice To Haves
- Solid understanding of the healthcare revenue cycle.
- Demonstrated ability to work in teams and communicate effectively with all levels.
Responsibilities
- Supervise PFS staff and daily billing, cash-posting, and collections operations.
- Lead in a manner that fosters trust and teamwork, maintain open communication, provide feedback, and seek employee input on relevant policies and procedures.
- Ensure employees understand State and Federal rules and regulations and have appropriate tools and opportunities for training and development.
- Drive cash collection and accounts-receivable resolution, working with payers to resolve and escalate issues.
- Manage expected reimbursement variances and work with departments to ensure the accuracy of 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 for meeting departmental and facility goals; coordinate with IT on changes needed to maintain billing accuracy.
- 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; initiate changes where appropriate to address payer issues, underpayments, and denials.
- Review and approve credit arrangements, refunds, write-offs, and account adjustments in accordance with departmental and medical center signature policies.
- Manage employee follow-up on third-party and self-pay accounts after initial billing.
- Prepare, distribute, and present required daily, weekly, and monthly reporting packages; ensure reports are completed on time and monitor department performance and productivity.
- 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 requirements and procedures for reporting issues.
- Attend relevant internal and external seminars and share information with staff and appropriate departments.
- Review and maintain JACHO requirements for billing, cash posting, and collections.
- Complete assigned special projects within established time frames and document each worked account in the patient accounting system.
- Ensure established goals are met and 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, daily Patient Accounting and Billing Scrubber reports for departments, department logs for claims on hold, and daily electronic and paper claim reports, along with other requested reports.
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.
- Flexible benefits package.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
