MINIMUM MANDATORY qualifications

Experience:

Education:

• Minimum five (5) years experience in managing hospital admissions, business office or related area. Proven performance improvement and change management experience.
• Bachelor’s Degree in Business Administration or Financial Management or seven (7) years of healthcare management and supervisory experience.

Mandatory Knowledge, Skills, Abilities and Other Qualifications:

• Knowledge of healthcare revenue cycle, including hospital billing, professional billing, and reimbursement.
• Ability to demonstrate core understanding of third-party billing and collection processes with particular focus on billing cash management requirements.
• Comprehensive understanding and knowledge of the Center for Medicare and Medicaid Servicers (CMS) Commercial and all other payers billing and compliance requirements.
• Extensive Knowledge of patient financial services activities including the HCPCS coding system, the ICD1-10 coding system, revenue, claims, denials, and collection practices.
• Must have high level of analytical skills, process improvement abilities, and problem-solving skills.
• Strong computer Microsoft and Excel skills.

Preferred qualifications

• Bilingual skills in English and Spanish languages.

essential Duties, functions & Responsibilities

• Maintains Customer Service excellence standards at all times and holds staff accountable to the standards.

• Communicates regularly with employees to inform them of hospital plans, priorities, and concerns.

• Ensures that each new department member has a thorough orientation to job responsibilities.

• Serves as a subject matter expert between the department, third party vendors, and other Revenue Cycle stakeholders to proactively identify opportunities to improve the revenue cycle and assist in resolution of issues.

• Demonstrate the ability to meet performance goals to include cash, A/R days, productivity by area, denial reduction, quality measures, staff productivity and other Revenue Cycle KPI’s.

• Responsible areas of direct oversight may include Billing, AR Management, Customer Service, Cash Posting, Denial Management, and overall Revenue Cycle operations.

• Maintains department policies and procedures as accurate descriptions of current work practice.

• Member of the Revenue Cycle Team.

• The Patient Financial Services Director provides overall administrative and organization directions to ensure that the Patient Accounts Department are managed effectively as evidenced by the Chief Financial Officer’s observation.

• Performs other duties as assigned by Chief Financial Officer.

• Works closely with the CFO and HIM Director to monitor DNFB report and maintain goal of unbilled days in AR less than 5.

• Works with CFO to reduce Bad Debt Expense and Days in AR through aggressive collection and follow up efforts. Works to ensure current benchmarks for Days in AR continues to be met.

• Acts as liaison with the clinical and ancillary departments, PFS Office, Finance and HIM to facilitate optimal patient flow and exchange of information. Assumes responsibility for department and inter-departmental communications to ensure information is shared for effective operations and to promote positive employee relations between the departments.

• Implements process to processes to guarantee the integrity of financial information that is directly related to the billing, collections and transfer processes.

• Monitors billing activity to ensure minimal backlogs.

• Monitors A/R by class and age to ensure an adequate turnaround of accounts.

• Prints special reports to assist in evaluating certain section of A/R. Takes action to address potential problems identified.

• Works with Early Out Vendor and Bad Debt Agencies to endure quality with outside vendors ensues.