Director of Patient Financial Services, Revenue Cycle - FT 8AM - 4PM

Under the direction of the Chief Revenue Officer, the Director of Patient Financial Services will coordinate and supervise the work in the office of Hospital Patient Accounting/Billing. This position will be responsible for providing operational oversight and strategic direction of the revenue cycle process including Patient Financial Services departments to obtain timely and accurate reimbursement for hospital  services rendered. Coordinates with applicable Hospital departments and functions to ensure accurate accounts receivable reporting and that accounts receivable and general ledger system mapping are provided in an accurate and consistent manner. This position will develop and implement policies, procedures and systems to ensure effective patient revenue capture and collection, contract payment and denial monitoring, regulatory compliance and standardization while exemplifying our Mission, Vision and Values as well as excellent customer service. The Director of Patient Financial Services will have the primary responsibility for direct supervision and overall operations of the Hospital Patient Accounting Department.  In addition, this position works collaboratively with Patient Access, Revenue Integrity, Health Information Management, Compliance, Professional and Ancillary Billing, and Case Management to ensure optimal performance and outcomes of the hospital’s revenue cycle.  In addition to performing the essential functions listed below, may also be assigned other duties as required.

·   Education

·   Licensure

·   Work Experience

·   Skills/computer/ specific technical

§ Other qualifications, miscellaneous 

Specify if qualifications are Required or Preferred 

1. Develops departmental goals and objectives for all areas of responsibility including financial counseling, insurance verification, cashiering, billing and follow-up/collections.
2. Assists area managers in establishing reasonable goals and objectives as well as consistent reporting tools. Monitors reports to ensure revenue and cash integrity. Conducts periodic reviews and provides constructive feedback on performance or training issues. Develops, updates and implements all policies and procedures for areas of responsibility.
3. Facilitates the incorporation of regulatory requirement changes into operational procedures for revenue cycle departments, provides guidance in implementation of new requirements or applicable laws. Maintains and disseminates regulatory requirements and communicates changes timely and effectively.
4. Responsible for monthly financial and statistical reporting, budget variance explanations and communicating barriers to goal achievement.
5. Distributes information to educate, monitor, and provide feedback to employees and physicians regarding their involvement and impact on revenue cycle, including any impact on reimbursement for services rendered.
6. Facilitates implementation of automation or electronic data exchange throughout the revenue cycle process, including CDM updates, insurance verification, bill holds and CCI edits, claims submission and payment remittance, bad debt referrals and recoveries.
7. Monitors Payor performance related to accurate and timely payment, and denial tracking to provide feedback to Contract Management.
8. Anticipates and plans accordingly to respond to changes in the reimbursement environment, and plans the appropriate procedures to be followed by revenue cycle departments to ensure maximum reimbursement for services rendered.
9. Evaluates utilization of systems and whenever possible and reasonable maintains standardization for systems related to revenue cycle. Recommends and facilitates new and current system development specific to the needs of revenue cycle.
10. Provides guidance and assists in development of protocols and procedures to address coding and clinical documentation processes, physician record completion and by-law compliance with regards to bill holds and CCI Edits, including tracking, monitoring and feedback to all revenue departments and physicians.
11. Coordinate with Revenue Integrity Director to ensure standardization of CDM, including utilization of systems, pricing and mark up policies and charge processing policies and procedures.
12. Identifies and mediates problem situations, and analyzes cause(s). Reviews late charge and other revenue reports to identify charge processing issues, plans and assists resolution implementation.
13. Interfaces with physicians, clinical departments, third party payers, fiscal intermediaries, government and other pertinent agencies as appropriate to facilitate effective working relationships and partnerships in order to maximize reimbursement.
14. Investigates and applies appropriate resolution of patient billing issues, including design, timing and messaging of patient statements in coordination with WHHS leadership.
15. Monitors and approves material write-offs, adjustments, and refunds within limits per policy.
16. Approves purchase orders and requisitions within limits established by policy.