Job Description

Where compassion meets innovation and technology and our employees are family.

Thank you for your interest in joining our team! Please review the job information below.

General Purpose of Job:

Oversee all aspects of Patient Financial Services and Central Billing Office including insurance billing, insurance claims follow up, credit balances, collections and any outsourcing to the extended business offices to ensure the financial viability of the organization in accordance with state and federal reimbursement guidelines. Responsible for achieving cash collections and the aging of Accounts Receivable percentage goals. The Director is over the CPSST credentialling team to ensure the providers get enrolled with federal and state payers in accordance with mandatory guidelines. The Director of PFS & CBO will routinely interact with various internal and external contacts including executive management, patient families, department directors, third party payers, government agencies, fiscal intermediaries, vendors, and physicians. Therefore, this position requires a candidate who demonstrates strong technical knowledge and expertise as well as excellent written communication skills and professional appearance and approach. The candidate must be able to manage multiple projects and handle potentially stressful situations. A verifiable background in medical accounts receivable management in a director or Manager position and a demonstrated record of achievements are required for this position.

Essential Duties and Responsibilities:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the CFO or VP of CPSST as required.

• Maintains utmost level of confidentiality at all times.
• Adheres to hospital policies and procedures.
• Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
• The Director of PFS & CBO will be responsible for effective performance of both departments.
• Responds to all customer inquiries in a timely and professional manner to ensure customer satisfaction. Customer is defined as all individuals requiring service from DCH (ie: patients, providers, payers, and other DCH associates).
• Demonstrates a positive attitude and serves others with personal service 100% of the time.
• The Director is often the last contact the DCH patient has with the institution; therefor this position requires a candidate who demonstrates a positive demeanor, good verbal and written communication skills, and is professional in both appearance and approach.
• The Director must demonstrate strong interpersonal and persuasive abilities in order to establish and maintain a positive relationship with other department leadership and staff at all levels.
• Oversee the hiring of all personnel with the departments
• Ensures compliance with DCH and all state and federal guidelines regarding patient billing, insurance billing, and outsourcing accounts.
• Oversee developing and revising policies and procedures for both departments.
• Ensure performance standards are achieved as described in each individual job description
• Ensure annual reviews are done timely and accurately.
• Monitor and track accounts receivable performance including: Monthly cash collections, Accounts Receivables Aging, Monthly bad debt write-offs, Monthly contractual and other adjustments, Billing productivity, Collection agency performance, Returned claims/billing rejections, Third party denials
• Answer leadership questions and provide appropriate guidance on actions to be taken.
• Develop or evaluate training plans for staff development for both departments
• Accountable for implements and monitoring activity related to the financial budget
• Monitor credit balance totals and return overpayments identified within state and federal guidelines
• Attend and participate in at least 16 hours of compliance-related training annually in addition to the annual hospital-wide compliance training.
• Ensure maximization of collection dollars from payers and in coordination with the contract manager
• Develop and monitor specific objectives, budgets, and performance standards for each area of responsibility to evaluate opportunities for cost savings and quality improvement.
• Participates, supports, and completes all DCH training activities.
• The Director must be a positive role model for staff
• The Director must develop procedures, organize personnel and flow and prioritize department initiatives.
• Actively searches for solutions to problems and streamline work processes
• Holds staff accountable for achieving performance measures
• Understanding of compliance, managed care, insurance contractual arrangements, inpatient, outpatient and rehabilitation billing and follow up, electronic and manual billing requirements and appeals process required.
• Analytical skill required to address complex issues

Supervisory Responsibilities:

• Effectively administers performance management system including: developmental feedback, goal setting, assesses competency, progressive discipline
• Strong knowledge of and effective in administering policies and procedures.
• Responsible for sound management of human resources.
• Makes and implements decisions compatible with organizational goals.
• Maintains composure, effectiveness, and flexibility under pressure.

Education and/or Experience:

• Bachelor’s degree (B. A.) from four-year college or university; or three to five years related experience and/or training; or equivalent combination of education and experience. Minimum two to three years’ experience in Manager and/or Director position preferred.