Patient Financial Services Manager

West Tennessee Healthcare • White Deer, TX

1d

About The Position

The Patient Financial Services (PFS) Manager is responsible for overseeing the following functions, as assigned: Billing, Accounts Receivable Follow-up, Payment Discrepancy (Denials/Underpayments), Credits, Self-Pay Processing, Payment Posting, and Customer Services. The PFS Manager is responsible for assisting with the overall departmental planning, trend analysis and evaluation of the department’s performance and providing regular performance updates to the MCMP Director and MCIS Pharmacy Manager. The Manager of PFS will have multiple direct reports The Manager of PFS will be the liaison to the outsourced billing company and responsible for all interaction with them. ESSENTIAL JOB FUNCTIONS: Leadership Maintains and enhances properly functioning enterprise-wide PFS processes. Conceptualizes, develops and implements all policies and procedures for the assigned departmental functions. Establishes long and short term unit goals and objectives to support department and corporate strategic plan. Monitors the progress of the departments' short and long-term goals. Maintains professional competency, according to department policies, procedures and protocols. Assumes responsibility for professional growth and development. Coordinates communication with departments, sites, and patient access to reduce recurring errors and denials and establish appropriate prevention measures. Establishes annual and monthly department and performance goals jointly with the MCMP Director and the MCIS Pharmacy manager. Seeks ways to control costs without compromising the quality of services delivered. Reviews changes in processes or payer requirements; communicates shifts in healthcare trends, rules and regulation changes to assigned PFS functional area. Champions organization objectives and change in the unit. Assists with and/or prepares annual capital and operating budgets. Monitors fiscal performance on a monthly basis to include variance reporting. People Responsible for the recruitment and retention of qualified staff, as well as the appropriate orientation, development and on-going training of staff. Coordinates all training, coaching, development, performance reviews and termination decisions for assigned talent. Leads and coordinates ongoing staff evaluation, retention, training and management of policies and procedures. Establishes expectations and holds staff accountable for talent and learning requirements (e.g., educational hours, organizational policies, etc.). Demonstrates leadership and commitment to staff and colleagues by accepting accountability for outcomes, sharing timely information, building effective relationships and communicating clearly and directly. Coordinates and prioritizes assigned activities to achieve maximum productivity. Supervises and monitors the daily activities of assigned personnel. Reviews personnel productivity reports for quantity and quality of collection and billing efforts, and provides feedback to the MCMP Director and Pharmacy Manager. Develops and implements effective training programs to address training needs of the department. Responsible for appropriate conduct management of staff members. Performs conflict-resolution, presents employee commendations, conducts problem solving and implements progressive disciplinary actions appropriate to organizational policies and procedures. Ensures that employee performance evaluations are conducted in a timely manner, are fair and consistent and that performance expectations are communicated. Adheres to established departmental policies for attendance, punctuality, procedures and safety. Prepares work schedules, authorizes overtime and time off, assesses and adjusts staffing levels based upon workload. Complies with organizational policies and procedures. Process Ensures accurate and timely processing of account recovery in compliance with performance and quality standards. Demonstrates proficiency and ability to oversee staff performing the following functions: Billing, Accounts Receivable Follow-up, Payment Discrepancy (Denials / Underpayments), Payment Posting and Cash Reconciliation, Credit / Refunds, Self-Pay Processing (including qualifying accounts for charity care / bad debt), Customer Service Develops efficient and effective policies and processes for assigned functional area, and seeks approval from MCMP Director and the MCIS Pharmacy Manager. Implements efficient and effective operational policies, processes and performance monitoring across assigned functions of the MCMP/MCIS Department. Ensures Patient Financial Services staff across assigned functions complies with established policies, processes, and quality assurance programs. Coordinates with other organizational areas to ensure timely processing of accounts receivable. Identifies and resolves problems in PFS processes, and, when appropriate, initiates changes to prevent future problems. Works with the Information Systems Department to escalate and resolve relevant issues to maintain day-to-day operations. As necessary, participates in review and selection of relevant technology enablers / tools to support PFS and other revenue cycle functions. Oversees the handling of "special handling" requests, complaints or inquiries regarding patient accounts to ensure correct and satisfactory resolution. Utilizes thorough knowledge of all phases of the billing, follow-up, cash posting, self-pay processing, credits and customer services processes. Utilizes knowledge of contractual constraints and federal and state regulations pertaining to billing and monitor impact on organizational receivables. Works to ensure full utilization of technology and processes to create an efficient and effective department. Attends periodic meetings with payer representatives and/or managed care contracting to discuss discrepancies and assist in developing action plan for correction. Manages activities required to initiate legal proceedings, employ private collection agencies, or special arrangements for delinquent accounts. Oversees outsourced billing services and vendor management relations and monitoring of outsourced billing services and vendor performance. Tracks and analyze major federal and state reimbursement changes which would affect operations, follow-up and revenue collection. Performance Monitoring Establishes Key Performance Indicators that the department will be expected to meet and exceed. Establishes the performance improvement initiatives and coordinates accordingly with department leadership to develop and implement appropriate action plans across the functions. Drives accountability across PFS management and staff based on responsibilities outlined in the Service Level Agreement. Measures and reports ongoing financial and operational performance of the PFS department. Recognizes areas of excellence and oversees the development and implementation of action plans within specific areas of PFS where performance is not meeting expectations. Interprets and communicates key revenue cycle performance indicators; reports key findings to appropriate leadership. Oversees the identification, resolution, and reporting of operational and financial issues and trends that impact patient service revenue. Other Takes personal accountability for professional growth and development. Performs related responsibilities as required or directed.

Requirements

• Bachelor’s degree preferred in Business, Health Administration or related degree; equivalent work experience may substitute degree requirement.
• Leadership Experience: 3-5 years
• Revenue Cycle or related Patient Financial Services experience (DME accounts receivable and business office management preferred): 5-7 years
• Significant understanding of healthcare business and finance principles, with special emphasis on hospital and physician accounts receivables.
• Demonstrated knowledge of healthcare management, registration, billing and collection processes for government, grant, and non-government funding sources.
• Demonstrated knowledge of federal and state payer reimbursement rules and regulations, ICD-9/ICD-10, and CPT coding practices.
• Knowledge of computer applications and equipment related to work.
• Strong organizational skills, working effectively in a multi-task environment, prioritizing tasks properly, and completing tasks/projects in a timely manner.
• Demonstrated proficiency in written and verbal communication skills.
• Demonstrated ability in leadership.
• Ability to relate cooperatively and constructively with clients, families, co-workers, administration, other clinic departments, providers, community agencies, referral sources and other health team members.
• Ability to work in a fast paced environment and remain flexible under stressful situations.

Responsibilities

• Maintains and enhances properly functioning enterprise-wide PFS processes.
• Conceptualizes, develops and implements all policies and procedures for the assigned departmental functions.
• Establishes long and short term unit goals and objectives to support department and corporate strategic plan.
• Monitors the progress of the departments' short and long-term goals.
• Maintains professional competency, according to department policies, procedures and protocols.
• Assumes responsibility for professional growth and development.
• Coordinates communication with departments, sites, and patient access to reduce recurring errors and denials and establish appropriate prevention measures.
• Establishes annual and monthly department and performance goals jointly with the MCMP Director and the MCIS Pharmacy manager.
• Seeks ways to control costs without compromising the quality of services delivered.
• Reviews changes in processes or payer requirements; communicates shifts in healthcare trends, rules and regulation changes to assigned PFS functional area.
• Champions organization objectives and change in the unit.
• Assists with and/or prepares annual capital and operating budgets.
• Monitors fiscal performance on a monthly basis to include variance reporting.
• Responsible for the recruitment and retention of qualified staff, as well as the appropriate orientation, development and on-going training of staff.
• Coordinates all training, coaching, development, performance reviews and termination decisions for assigned talent.
• Leads and coordinates ongoing staff evaluation, retention, training and management of policies and procedures.
• Establishes expectations and holds staff accountable for talent and learning requirements (e.g., educational hours, organizational policies, etc.).
• Demonstrates leadership and commitment to staff and colleagues by accepting accountability for outcomes, sharing timely information, building effective relationships and communicating clearly and directly.
• Coordinates and prioritizes assigned activities to achieve maximum productivity.
• Supervises and monitors the daily activities of assigned personnel.
• Reviews personnel productivity reports for quantity and quality of collection and billing efforts, and provides feedback to the MCMP Director and Pharmacy Manager.
• Develops and implements effective training programs to address training needs of the department.
• Responsible for appropriate conduct management of staff members.
• Performs conflict-resolution, presents employee commendations, conducts problem solving and implements progressive disciplinary actions appropriate to organizational policies and procedures.
• Ensures that employee performance evaluations are conducted in a timely manner, are fair and consistent and that performance expectations are communicated.
• Adheres to established departmental policies for attendance, punctuality, procedures and safety.
• Prepares work schedules, authorizes overtime and time off, assesses and adjusts staffing levels based upon workload.
• Complies with organizational policies and procedures.
• Ensures accurate and timely processing of account recovery in compliance with performance and quality standards.
• Demonstrates proficiency and ability to oversee staff performing the following functions: Billing, Accounts Receivable Follow-up, Payment Discrepancy (Denials / Underpayments), Payment Posting and Cash Reconciliation, Credit / Refunds, Self-Pay Processing (including qualifying accounts for charity care / bad debt), Customer Service
• Develops efficient and effective policies and processes for assigned functional area, and seeks approval from MCMP Director and the MCIS Pharmacy Manager.
• Implements efficient and effective operational policies, processes and performance monitoring across assigned functions of the MCMP/MCIS Department.
• Ensures Patient Financial Services staff across assigned functions complies with established policies, processes, and quality assurance programs.
• Coordinates with other organizational areas to ensure timely processing of accounts receivable.
• Identifies and resolves problems in PFS processes, and, when appropriate, initiates changes to prevent future problems.
• Works with the Information Systems Department to escalate and resolve relevant issues to maintain day-to-day operations.
• As necessary, participates in review and selection of relevant technology enablers / tools to support PFS and other revenue cycle functions.
• Oversees the handling of "special handling" requests, complaints or inquiries regarding patient accounts to ensure correct and satisfactory resolution.
• Utilizes thorough knowledge of all phases of the billing, follow-up, cash posting, self-pay processing, credits and customer services processes.
• Utilizes knowledge of contractual constraints and federal and state regulations pertaining to billing and monitor impact on organizational receivables.
• Works to ensure full utilization of technology and processes to create an efficient and effective department.
• Attends periodic meetings with payer representatives and/or managed care contracting to discuss discrepancies and assist in developing action plan for correction.
• Manages activities required to initiate legal proceedings, employ private collection agencies, or special arrangements for delinquent accounts.
• Oversees outsourced billing services and vendor management relations and monitoring of outsourced billing services and vendor performance.
• Tracks and analyze major federal and state reimbursement changes which would affect operations, follow-up and revenue collection.
• Establishes Key Performance Indicators that the department will be expected to meet and exceed.
• Establishes the performance improvement initiatives and coordinates accordingly with department leadership to develop and implement appropriate action plans across the functions.
• Drives accountability across PFS management and staff based on responsibilities outlined in the Service Level Agreement.
• Measures and reports ongoing financial and operational performance of the PFS department.
• Recognizes areas of excellence and oversees the development and implementation of action plans within specific areas of PFS where performance is not meeting expectations.
• Interprets and communicates key revenue cycle performance indicators; reports key findings to appropriate leadership.
• Oversees the identification, resolution, and reporting of operational and financial issues and trends that impact patient service revenue.
• Takes personal accountability for professional growth and development.
• Performs related responsibilities as required or directed.

What This Job Offers

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