Job Description

• Department: Revenue Cycle Management
• Schedule: Monday-Friday 9-5
• Hospital: Witham Health Services
• Location: 2605 N Lebanon St, Lebanon, IN 46052 (South Pavillion)

Directs all Patient Financial Services operations including billing, collections, cash posting, denial management, customer service, and self-pay programs. Owns the department's financial performance metrics and is accountable for meeting established targets for AR days, cash collections, denial write-off rates, and clean claim rates. Manages staff, vendors, and cross-departmental relationships; surfaces issues and solutions proactively to the Executive Director of Revenue Cycle. This is a hands-on leadership role requiring equal comfort with data analysis and people management.

Minimum Requirements:

Required:

• Bachelor's degree in Healthcare Administration, Business, Finance, or related field

• Working knowledge of CPT, ICD-10, HCPCS, revenue codes, APCs, DRGs, and payer reimbursement methodologies

• Minimum five (5) years of progressive healthcare revenue cycle experience, including at least three (3) years in a supervisory or management role in a hospital business office setting

• Direct experience with hospital billing and collections for Medicare, Medicaid, managed care, and commercial payers

• Demonstrated experience managing accounts receivable performance to specific benchmarks

• Proficiency in Excel and comfort with data analysis tools

Preferred:

• Experience with Meditech EHR (Expanse preferred) and Waystar or comparable clearinghouse/RCM platform

• Experience with revenue cycle automation or predictive denial analytics tools

Continuing Education:

This position requires ongoing continuing education in Medicare, Medicaid, and commercial insurance billing; federal and state revenue cycle compliance (price transparency, No Surprises Act, 501(r)); and revenue cycle leadership and analytics.

Required Competencies:

This position requires the following skills and abilities:

1. Independently analyzes AR, cash, denial, and write-off data to identify trends, root causes, and opportunities; translates findings into actionable recommendations with dollar impact and defined next steps
2. Produces monthly financial and operational reports for executive leadership
3. Manages staff performance through quality audits, timely evaluations, and structured coaching; addresses performance and conduct issues promptly and directly
4. Works independently to maintain the department's operational rhythm; communicates status, risks, and progress proactively
5. Deep understanding of the full revenue cycle from patient access through final resolution
6. Working knowledge of federal and state billing regulations: Medicare/Medicaid compliance, HIPAA, No Surprises Act, and 501(r)
7. Maintains confidentiality of all patient and financial information
8. Maintains composure under pressure; represents the department professionally to physicians, executives, board members, and patients
9. Exemplifies excellent guest relations with patients, staff, physicians, and the public

Essential Functions:

A.Financial Performance and Data Analysis

1. Maintains hospital and professional AR days at or below benchmark targets; monitors daily and acts when trends move in the wrong direction

2. Produces monthly performance reports covering AR days and aging, cash collections vs. budget, denial rates and write-off categories, clean claim rate, and unbilled AR; delivers to the Executive Director on an established schedule

3. Conducts root cause analysis on any metric that misses target: dollar impact, affected population, contributing factors, and corrective action plan with timeline

4. Monitors daily cash posting and investigates variances; tracks credit balances and ensures refunds are processed within regulatory timelines

B.Denial Management

1. Owns denial management end to end: tracks and trends denials by payer, reason code, and dollar amount; oversees appeals and outcomes; reports results monthly; and drives cross-departmental root cause resolution with Patient Access, Coding, and clinical departments
2. Reduces preventable denials through process improvement and staff education; routes clinical denials (medical necessity, level of care) to staff with appropriate clinical/appeal expertise

C.Billing Operations, Vendor Management, and Compliance

1. Ensures timely and accurate claim submission for all payer types; monitors clean claim rate and addresses root causes of claim rejections
2. Manages all PFS vendor relationships: AR follow-up vendors, collection agencies, clearinghouse/RCM platform, and patient statement and payment portal vendors; reviews invoices and manages contracts through renewal/termination cycles
3. Maintains compliance with all federal, state, and payer-specific billing regulations; develops, maintains, and enforces department policies and procedures
4. Owns price transparency compliance (machine-readable file and shoppable services tool), No Surprises Act compliance (Good Faith Estimates, dispute resolution readiness), and 501(r) compliance for the billing and collections side
5. Manages the patient billing and statement process, including customer service for billing inquiries and payment plan administration

D.Staff Management and Quality Oversight

1. Directly supervises PFS managers, supervisors, and/or team leads; indirectly oversees all PFS staff

2. Conducts monthly quality audits: reviews a defined sample of accounts per collector to assess note quality, follow-up appropriateness, and protocol adherence; documents results and provides feedback

3. Manages the worklist system: ensures accounts are distributed equitably, queues are current, and no account goes unworked past established thresholds

4. Completes performance evaluations on time with specific, measurable feedback; creates and follows through on performance improvement plans when warranted

5. Develops staff through ongoing training, cross-training, and professional development planning; identifies succession risks

E.Patient Financial Experience and Technology

1. Owns the patient financial experience: pre-service cost estimates, clear statements, and responsive billing customer service; ensures financial counseling and charity screening are offered consistently before accounts move to collections
2. Identifies and sponsors automation and technology opportunities across PFS; governs revenue cycle tools for accuracy, compliance, and measurable return

F.Communication, Collaboration and Administration

1. Communicates proactively with the Executive Director on department status, risks, wins, and needs; represents PFS in cross-departmental meetings

2. Resolves patient, physician, and interdepartmental complaints professionally and promptly

3. Participates in budget development; manages department expenses within approved budget

4. Supports hospital mission, values, and strategic plan; maintains 24-hour accountability for department operations

5. Ensures a safe, respectful, and professional work environment in compliance with infection control, hazardous materials, disaster/fire safety, and general safety policies

6. Additional duties as assigned

Accountability for Performance Metrics:

This role is accountable for maintaining revenue cycle performance metrics at or above established targets.