Manager PFS Billing

Salinas Valley Health • Salinas, CA

19h • Onsite

About The Position

The Patient Financial Services billing Manager oversees the day-to-day operations of SVMH’s accounts receivable (AR) for billing and collections of insurances for the purposes of liquidation of AR timely, achieving aging thresholds, minimizing avoidable and controllable write-offs through issue identification and escalation. The PFS Billing Manager works closely with leaders and staff to manage processes, staff and technology in pursuit of leading revenue cycle outcomes. Monitors and manage AR through communication within staff, payers and other hospital revenue cycle departments. Organizes and directs the work of PFS personnel by scheduling, evaluating performance, resolving employee complaints, and administering discipline when necessary. Responsible for the quality of work, productivity of staff, morale of the groups and employee adherence to hospital and departmental policies, procedures and guidelines. Provides leadership and supervision regarding departmental performance by completing evaluations, maintaining staff competency and development, adequate staffing and assures all work in specified areas is completed while maintaining a high level of quality. Is a role model for departmental behavior, and provides and promotes a positive working environment for departmental staff to ensure strong employee morale, motivation and productivity. Supervises the PFS billing and collections workflow to ensure the department’s role and function in the Healthcare System supports the delivery of the highest possible standard of patient care, and customer service for staff and visitors within the available resources. Monitors and oversees the PFS billing and collections staff’s, scheduling, work assignments, and corrective actions. Oversees AR functions; develop, implement, monitor and analyze all functions related to billing and collections to ensure leading revenue cycle operational performance is consistent of meeting cash goals and aging thresholds along with other revenue cycle benchmarks. Also monitor credit balance reports and refund requests to ensure timely resolution and response. Ensures employee productivity and quality of work meets QA standards, through preparation and presentation of staff productivity reports. Stays current with payer/claim specific issues and facilitates resolution through communication and coordination with health plans, PFS leaders and attend Joint Operation Committee (JOC) Meetings as needed. Works with Finance Division Support Team to assist with identifying underpayments and manage other necessary report requirements across the organization. Monitors the collection processes to identify cash flow improvement opportunities. Monitors, identifies and reports any system issues negatively impacting A/R. Ensures timely submission of requested information from various payors and health plans. Provides daily monitoring and monthly reporting of Key Performance Indicators and Department performance dashboard data as requested. Provides feedback and education to ancillary departments regarding reimbursement processes and assist with resolution of AR issues directly associated with these processes as needed. Expected to demonstrate strong leadership skills and the ability to motivate team members. Serves as a resource and promotes positive interactions with customers and employees in an effort toward exceeding expectations or any persons associated with the hospital. Assist with the development of department policies and procedures. Provides and/or coordinates orientation and training of staff. Issues performance appraisals and conducts reviews according to hospital guidelines to ensure completion by due date 100% of the time. Assists with interviewing of potential employees. Monitors equipment performance and contacts appropriate department/vendor for necessary service. Attends meetings and in-services, works on special projects as requested/needed, and performs other duties as assigned.

Requirements

• Bachelor’s degree in Healthcare Administration, or Business Administration required (New hires/transfer have a three (3) year grace period to obtain a Bachelor’s degree).
• A minimum of five (5) years’ experience in hospital business office at a manager level required.
• Extensive experience working with billing, collection and reimbursement procedures required.
• Familiarity with medical terminology and coding systems (ICD-10, HCPCS, CPT’s, APC, DRG’s, etc...) highly preferred.

Nice To Haves

• Familiarity with medical terminology and coding systems (ICD-10, HCPCS, CPT’s, APC, DRG’s, etc...)

Responsibilities

• Oversees the day-to-day operations of SVMH’s accounts receivable (AR) for billing and collections of insurances.
• Manages processes, staff, and technology to achieve leading revenue cycle outcomes.
• Monitors and manages AR through communication with staff, payers, and other hospital revenue cycle departments.
• Organizes and directs the work of PFS personnel, including scheduling, performance evaluation, and disciplinary actions.
• Ensures the quality of work, productivity, and morale of the PFS team.
• Provides leadership and supervision regarding departmental performance, including staff competency, development, and adequate staffing.
• Supervises the PFS billing and collections workflow to support patient care and customer service standards.
• Develops, implements, monitors, and analyzes all functions related to billing and collections.
• Monitors credit balance reports and refund requests for timely resolution.
• Ensures employee productivity and quality of work meet QA standards.
• Stays current with payer/claim specific issues and facilitates resolution.
• Works with the Finance Division Support Team to identify underpayments and manage report requirements.
• Monitors collection processes to identify cash flow improvement opportunities.
• Monitors, identifies, and reports system issues impacting A/R.
• Ensures timely submission of requested information from payors and health plans.
• Provides daily monitoring and monthly reporting of Key Performance Indicators and Department performance dashboard data.
• Provides feedback and education to ancillary departments regarding reimbursement processes.
• Assists with the development of department policies and procedures.
• Provides and/or coordinates orientation and training of staff.
• Issues performance appraisals and conducts reviews according to hospital guidelines.
• Assists with interviewing potential employees.
• Monitors equipment performance and arranges for necessary service.
• Attends meetings and in-services, works on special projects, and performs other duties as assigned.

Benefits

• None explicitly mentioned, but the company states "It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business."

What This Job Offers

• Job Type: Full-time
• Career Level: Manager