Director Patient Financial Services

Job Description Summary

The Director Patient Financial Services is responsible to plan, direct and oversee all aspects of Patient Financial Services Department including but not limited to all hospital and physician billing and collections. Responsibility also includes control of all cash posting transactions within the hospital and physician enterprises, as well as oversight of all third party vendors leveraged for unit support.

Job Description

ESSENTIAL FUNCTIONS

1. Oversees the hospital and physician billing operations and ensure that all Regulatory and Compliance guidelines are met.
a. Evaluate and conduct periodic reviews of claim dictionaries and claims editing software to remain in compliance and maximize claim efficiency.
b. Review denial management reports for trend analysis. make recommendations to reduce applicable denial categories
c. Identify areas of opportunity for Revenue enhancement by capturing missed charges, reducing late charges and compiling reports on new programs to ensure that charge capture is maintained.

2. Control all patient statement activity and maintain adherence to the hospitals Credit/Collection Policy.
a. Evaluate the department statement and letter process and make/recommend changes as needed to fortify self pay collections
b. Review collection activities and make recommendations to increase self pay cash performance.

3. Oversees all aspects of Collection Agency placement and performance.
a. Approve and initiate referrals to outside collection agencies or attorneys as determined in hospitals credit/collection policy to effect collections.
b. Review reports on overall productivity and evaluate agency performance for quarterly review with agencies.
c. Identify ways to reduce overall placements to Bad Debt including but not limited to additional technology, staffing needs etc.

4. Monitor key performance indicators for revenue cycle performance on a minimum weekly basis, addressing gaps with managers as needed and reporting key successes and resolution steps appropriately to the Executive Director of Revenue Cycle..
a. Monitor aged receivables, cash receipts and all outsourced accounts receivable to ascertain overall departmental performance. Collaborate with management staff and leverage Epic dashboards/reports to maximize efficiency.
b. Utilize available technology and outside resources to identify ways to reduce the Accounts Receivable. Collaborate with other Department Directors in Revenue Systems, Patient Access and Health Information Management for optimum results.
c. Establish a month end close process to ensure that both the revenue and contractual allowances are correct. The process includes review of charges greater than 20K. High balance open accounts greater than 30K as well as high dollar credit balances greater than 5K.

5. Prepare Departmental budget and maintain fiscal control over expenditures.
a. Prepare budget within assigned timeframe to area vice president for approval.

6. Embraces technological solutions and third-party vendor support to work processes and practices.
a. Evaluates and makes recommendations for available technology to enhance the billing and collection process.
b. Regularly evaluate need for third-party vendor support to ensure all claims are billed and processed timely to maximize reimbursement.

c. Facilitate third-party vendor RFP, review, selection and implementation process as appropriate.

7. Fosters a “Culture of Safety” through personal ownership and commitment to a safe environment.
a. Ensures staff commitment to safety via staff meetings and minutes.
b. Provides suggestion box for employees to recommend system improvements.

8 – Engage with Executive Director of Revenue Cycle on strategic planning for the department

9 – Review departmental policies on a routine basis and propose necessary changes as needed

10 – Dedicate comparable time across Hospital and Physician teams to ensure a healthy, robust revenue cycle

Technology and Learning
a. Participates in continued learning and possess a willingness and ability to learn and utilize new technology and procedures that continue to develop in their role and throughout the organization.
b. Embraces technological advances that allow us to communicate information effectively and efficiently based on role.

CONTACTS

Supervisory Responsibilities

Responsible for supervising others

        5 - Approximate number of direct reports

      35 - Approximate number of indirect reports

JOB REQUIREMENTS

Minimum Education - Preferred

Minimum of high school diploma, with extensive knowledge of specialized field equal to four years of college preparation preferred.

Minimum Work Experience

Minimum five (5) years proven experience in related field preferred.