Job Description
Job Description
Our Core Values
The culture at Prism Health North Texas is built on our shared Core Values. We make hiring, firing, promotion and performance review decisions based on these values and behaviors, so it is important that you also share these Core Values :
- We are solution seekers. The organization’s founders found solutions even during the AIDS crisis of the 80’s; we remain proactive, thrive on change, and always willing to take the lead.
- We have a can-do attitude . We are flexible, agile, and never say, “It’s not my job.” We always seek growth, and we are never late but always willing to stay late to see the last patient.
- We are mission driven . We are committed to health equity; recognize all contributions are meaningful and valued. It is never about the me or I, but about the we.
- We care about people . We celebrate diversity, equity, and inclusion; we are kind and practice acts of kindness, all in service to our patients and each other.
General description :
The Director of Clinical Finance (Director) bridges the Finance and Revenue Cycle teams and is responsible for analysis, reporting, and internal controls related to the accounting for Prism Health North Texas (PHNTX) patient service revenue and expenses. The Director ensures timely, appropriate, and accurate analyses are available related to the clinical practice and to patient accounts. The Director ensures correct accounting treatment of charges, payments, adjustments, and other patient account transactions.
Responsibilities
Specific Responsibilities of the Job :
Designs and prepares / oversees preparation of financial reports, budget-to-actual, and other analyses related to PHNTX’s clinical practice – including but not limited to profitability, productivity, inventory utilization, and similar measures both organization-wide and for individual providers, locations, and / or services.Designs and prepares / oversees preparation of reports and analyses related to PHNTX’s revenue cycle – including but not limited to monitoring occurrences and trends in important metrics such as encounters, charges, aging, timely claim submission, claim rejections, claim denials, etc. Identifies trends and problems, troubleshoots, and recommends solutions.Independently designs analyses and reports to address emerging business questions and support organizational decision-making. Requires the ability to understand and define the relevant variables and to extract and use data from multiple sources.Produces or oversees production of assigned variance analyses, year-round reforecasting, and estimates and scenario calculations for the annual budget.Establishes and monitors internal controls related to payments received toward patient care activities, posting to patient accounts, and payor deviation from contractual rates. Oversees payment posting and reconciliation.Periodically reviews and evaluates fee schedule in relation to appropriate market, costs, and contractual rates. Proposes appropriate new and revised fees. Proposes and participates in establishing and negotiating / renegotiating contractual fees with third party payors.Leads short and medium-term projects to identify, troubleshoot, and solve errors or anomalies in patient services accounting processes.Ensures accuracy, review & approval, and correct accounting treatment for write-offs, adjustments, and other patient account actions.Prepares and maintains bad debt reserve estimates and other calculations.Utilizes appropriate drivers to establish and maintain appropriate cost allocation methodologies for shared / common expenses among various programs, locations, and funding types.Plays a key year-round role in preparing for and producing the organization’s annual Medicare Cost Report.Participates in organizational initiatives, special projects, process improvement, audit support activities, annual budget, ERP evaluation / selection / implementation, etc., as assigned.Effectively trains, supervises, and develops more junior staff.Other duties as assigned.Required Skills
Required Knowledge, Skills and Abilities :
Proficiency understanding, accessing, reporting, and using data from an Electronic Medical Records / Electronic Health Records (EMR / EHR) systemProficiency understanding, accessing, reporting, and using data from an accounting / ERP systemData analysis and data visualization skills. Ability to design and present reporting in a compelling manner for varied audiences.Comprehensive understanding of Generally Accepted Accounting Practices (GAAP) and cost accounting principlesExcellent knowledge of financial reporting standards and principles, including those specific to HealthcareExcellent Excel skills. Excel Expert certification and / or facility with VBA / Macros / PowerQuery preferred. Standard MS Word and PowerPoint skill required.Understanding of patient accounts and the physician / professional billing revenue cycle processes.Excellent written and oral communication skills, including ability to teach / train / present to diverse audiences.Education and Experience :
Bachelor’s degree required. Master’s degree preferred. At least one degree should be in accounting, business, finance, business analytics, or a similar field.At least 7 years of paid work experience in a healthcare environment required.Understanding of ICD-10, CPT codes, physician billing, third party reimbursement and contracts. Billing / coding certification (such as CPC, CMC, RHIT / RHIA) a plus.The successful candidate will demonstrate critical thinking, problem-solving, and supervision / mentoring skills. The successful candidate will demonstrate a high level of rigor and accuracy, an eagerness to learn, a drive to establish efficient processes / workflows, and will work collaboratively and effectively as part of a multidisciplinary team. The candidate will work well with limited supervision and be able to consistently meet deadlines.
