JOB SUMMARY:

The Patient Financial Services Manager will also be responsible for all HAMC activities in accordance with current applicable federal, state, and local standards, guidelines, and regulations and is directed by the CFO, to ensure the proper administrative procedures are always maintained. The Patient Financial Services (PFS) Manager is also responsible for managing all non-clinical financial operations related to post-acute and ancillary care services.

GENERAL REQUIREMENTS:

• • Performs all job responsibilities in alignment with the mission and vision of the organization.
  • Performs other duties as needed and completes all job functions as per departmental policies and procedures.
  • Maintains current knowledge in present areas of responsibility (i.e., self-education, attends ongoing educational programs).
  • Attend staff meetings and complete mandatory in-services and requirements and competency evaluations on time.
  • Wear protective clothing and equipment as appropriate.

GENERAL SKILLS:

• • Ability to communicate in English, both verbally and in writing.
  • Strong written and verbal skills.
  • Basic Computer Skills

WORKING CONDITIONS:

• • General environment: Works in a well-lighted, air-conditioned area, with moderate noise levels.
  • May be exposed to high noise levels and bright lights.
  • This role typically operates in an office environment only.
  • May be exposed to limited hazardous substances or body fluids, or infectious organisms.
  • May be needed to change from one task to another or different nature without loss of efficiency or composure.
  • Periods of high stress and fluctuating workloads may occur.
  • May be scheduled as needed including overtime.

PHYSICAL REQUIRMENTS & DEMANDS:

• • Have near normal hearing: Hear alarms/telephone/normal speaking voice.
  • Have near normal vision: Clarity of vision (both near and far), ability to distinguish colors.
  • Have good manual dexterity.
  • Have good eye-hand foot coordination.
  • Ability to perform repetitive tasks/motion.
  • Continuously within shift (67-100%): Standing, Walking.
  • Frequently within shift (34-66%): Bending/Stooping, Pushing/Pulling, Lift/carry up to 20lbs, Lift/carry > 20 lbs. with assistance.
  • Occasionally within shift (1-33%): Sitting, Climbing, Twist at waist, Lift/Carry > 50 lbs. with assistance, Reaching above shoulder.

MISSION STATEMENT:

QUALITY HEALTHCARE: In our continuing effort to enhance the quality of life for the communities we serve, the Hospital Authority of Miller County is committed to the delivery of superior, safe, cost-effective healthcare through the provisions of education prevention, diagnosis and treatment.

JOB SPECIFIC COMPETENCIES:

• • • Keeps current on the latest business and technical developments through continuing education and educating staff accordingly.
    • Conducts employee performance appraisals according to HAMC guidelines.
    • Updates procedure manuals and job descriptions as operations and requirements change.
    • Demonstrates effective and proper oral and written communications.
    • Accepts special assignments from upper management and completes projects on time.
    • Selects and monitors outside collection vendors engaged in the collection of hospital receivables. Reviews and balances agency reports and approves agency invoices.
    • Ability to interpret an extensive variety of concepts such as billing/collection regulations and requirements.
    • Knowledge of medical terminology, ICD10 and CPT procedure coding.
    • Ability to effectively and appropriately communicate ensuring exceptional customer service.
    • Computer experience – Microsoft Word and Excel proficient.
    • Ability to perform multiple tasks, strong verbal and written skills and sound decision-making abilities.
    • Knowledge of HIPAA compliance requirements.

REVENUE CYCLE OVERSIGHT:

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• • • Direct and manage the full revenue cycle process from charge entry through payment posting and collections for all designated service lines.
    • Ensure prompt and accurate claim submissions and resolution of claim denials or rejections.
    • Oversee billing operations for Medicare, Medicaid, commercial insurance, and private pay across all services including:
• Skilled Nursing Facilities (SNF)
• Home Health Services
• Assisted Living Facilities (ALF)
• Adult Day Care
• Pharmacy Infusion Therapy
• Transportation Services (non-emergency, medical)
  • • Ensure compliance with federal and state regulations, including HIPAA and payer-specific billing requirements.

ACCOUNTS RECEIVABLE & REPORTING:

• • • Monitor and analyze accounts receivable trends and performance metrics.
    • Lead monthly A/R reviews and ensure targets such as days in A/R and collection percentages are met.
    • Prepare regular reports for leadership on financial performance, denials, and collection efforts.

TEAM LEADERSHIP

• • • Supervise billing and collection staff across assigned service lines.
    • Provide training, performance evaluations, and support to promote a culture of accuracy, accountability, and efficiency.

SYSTEM & WORKFLOW OPTIMIZATION:

• • • Collaborate with IT and EHR teams to optimize billing system functionality and integration.
    • Implement process improvements to enhance cash flow, streamline workflows, and reduce billing errors or delays.

COLLABORATION & SUPPORT:

• • • Serve as a liaison between finance, admissions, registration, and external vendors as needed.
    • Assist with payer audits and ensure documentation and billing practices support regulatory and contractual requirements.

PROFESSIONAL REQUIREMENTS:

• • Follows Code of Conduct policy.
  • Adheres to dress code; appearance is neat and clean.
  • Completes annual educational requirements.
  • Maintains regulatory requirements.
  • Always maintain patient confidentiality.
  • Reports to work on time and as scheduled; completes work within designated time.
  • Wears identification when on duty; use computerized time clock system correctly.
  • Completes in-services and returns in a prompt fashion.
  • Attends annual review and/or skills fair and department in-services, as scheduled.
  • Attempts to end conversations and other interactions in a positive manner leave others with a good impression of the Hospital Authority of Miller County and its employees.
  • Follows all organizational policies on ethical business practices.
  • Communicates the mission statement of the organization.

GUEST RELATIONS STANDARDS:

(All guest relation violations are subject to disciplinary action up to and including termination):

• • Always treat others in a friendly, helpful manner.
  • Refers co-workers to proper internal resources when unable to provide an answer.
  • Interact with others in a professional and friendly manner.
  • Takes interest in others and always gives full cooperation to fellow workers.
  • Always maintains an open line of communication with other departments.
  • Thoroughly familiar with the hospital and the services it offers.

OTHER:

• • Responsibility to Report: It is the responsibility of every employee of HAMC to comply with federal, state and local laws and regulations, as well as HAMC Policies and Procedures. Every employee is helping to participate in, comply with and report concerns to his or her supervisor or the Compliance Officer if illegal or unethical behavior is suspected.
  • As an employee of HAMC, you have been granted user access to applicable ePHI systems based on your position. This user or role-based access is intended to give you the minimum necessary access to perform your job function(s) only and should be used only as applicable.

OTHER DUITIES:

Please note this job description is not designed to cover or contain a comprehensive list of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice

EDUCATION, CREDENTIALS & EXPERIENCE REQUIREMENTS:

• A Bachelor’s degree in Healthcare Administration, Finance, Accounting, or a related field required.
• At least 2 years in a leadership or supervisory role.
• Working knowledge ranging from beginner to proficient level is acceptable, with a willingness to learn and grow in the role of Medicare, Medicaid, and commercial billing for SNF, Home Health, ALF, Adult Day Care, Pharmacy, Infusion, and Transportation services.
• Proficient in healthcare billing software and EHR systems; strong Excel and analytical skills.
• Excellent communication, organizational, and leadership abilities.
• Experience with systems such as MatrixCare, Brightree, or ModivCare billing will be helpful
• Working knowledge of PDPM, OASIS, HHA billing standards, and NCPDP for pharmacy billing will be helpful.
• Familiarity with non-emergency transportation billing under Medicaid and managed care plans.
• preferred CAH and RHC experience.
• Experience with the Federal, State and other healthcare payors in needed.