Director, Patient Financial Services (PFS) - Healthcare CBO

Job Family:

PFS General

Travel Required:

Up to 10%

Clearance Required:

None

What You Will Do:

The Patient Financial Services Director (Hospital Revenue Cycle) is responsible for the overall management of the Hospital Client PFS department operations, including patient accounting, credit and collections, denial management, and other related key revenue cycle activities. The Director will define and achieve departmental objectives, manage billing and follow-up of patient accounts, compliance with third party payer regulations, and work with company resources to assure ongoing improvements to key revenue cycle indicators.

• Leverage extensive experience with healthcare hospital billing systems including electronic claims and authorizations, to maximize revenue and cash flows.

• Leverage extensive knowledge of front and back end billing operations.

• Demonstrate knowledge of billing and coding regulations.

• Demonstrate proficiency with registration, eligibility, and third party verification, billing and collections.

• Extensive experience with healthcare hospital billing systems including electronic claims and authorizations, to maximize revenue and cash flows.

• Comprehensive knowledge of healthcare, billing, finance and accounting principles.

• Detailed knowledge and understanding of billing technical elements, such as standard forms and data, coordination of benefits, third party liability, billing and collection.

• Comprehensive knowledge of HFMA MAP metrics

• Ability to review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.

• Upon identification of issues, researches issue to determine whether it is an isolated instance or a trend and follows up the appropriate Revenue Cycle leadership to facilitate communication and resolution of the issues.

• Ability to successfully prioritize and manage numerous tasks simultaneously.

• Establishes and develops collaborative relationships with other leaders in the Revenue Cycle.

• Works with Managed Care Department for Underpayment Analysis.

• Attends and participates in committees and task forces as assigned.

• Prepares materials for and with experience conducts and chairs project meetings.

• Maintains current knowledge of regulatory standards, which may impact utilization of processes and systems.

• Seeks out opportunities for individual growth and development, including attending various meetings, conferences, and courses, as required.

• Participates in the development of PFS policies and procedures.

• Serves on department and/or institutional committees as requested.

• Leverage extensive experience with healthcare hospital billing systems including electronic claims and authorizations, to maximize revenue and cash flows.

• Collaborate, mediate, and resolve applicable items/issues between Finance and Hospital PFS.

• Possess skills in order to understand financial systems and patient accounts and ability to detect and resolve problems related to Accounts Receivable.

• Ensure compliance with relevant regulations and standards pertaining to Hospital PFS.

• Demonstrates an ability to plan, coordinate, implement and control Hospital Billing and Collection services and to function effectively in a management position in a complex centralized environment.

• Leverage extensive knowledge of front and back end billing operations.

• Demonstrate knowledge of billing and coding regulations.

• Demonstrate proficiency with registration, eligibility, and third party verification, billing and collections.

• Extensive experience with healthcare hospital billing systems including electronic claims and authorizations, to maximize revenue and cash flows.

• Performs all other job functions related to this job.

Staff:

• Hire, review, discipline and separate employment.

• Monitor and report daily/monthly productivity.

• Ensure Team Member compliance with company policies and procedures.

• Verify and monitor time off requests.

• Able to fill in for Managers.

What You Will Need:

• Requires a Bachelor's Degree and a minimum 12 years of prior relevant experience or Associate's Degree and a minimum 14 years of prior relevant experience.(Relevant experience may be substituted for formal education or advanced degree.

• Relevant experience coming from a healthcare provider, payor, CBO, business office environment or an outsourcing company

What Would Be Nice To Have:

• Understanding of healthcare revenue cycle, payer contracts and regulation affecting reimbursement for healthcare services.

• Excellent verbal, written, analytical and interpersonal skills.

• Ability to handle multiple concurrent activities and change.

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The annual salary range for this position is $130,000.00-$216,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance

• Personal and Family Sick Time & Company Paid Holidays

• Position may be eligible for a discretionary variable incentive bonus

• Parental Leave

• 401(k) Retirement Plan

• Basic Life & Supplemental Life

• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts

• Short-Term & Long-Term Disability

• Tuition Reimbursement, Personal Development & Learning Opportunities

• Skills Development & Certifications

• Employee Referral Program

• Corporate Sponsored Events & Community Outreach

• Emergency Back-Up Childcare Program

About Guidehouse

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or [email protected].  Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.  Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.

If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact [email protected]. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.