Oversees the management and supervision of the services through Managers, Supervisors, and staff. Creates a shared vision and integrates core purpose/mission and values into daily activities. Coaches, mentors and develops management team to ensure competence, alignment with organizational values and behaviors and ongoing professional development.
Plans and organizes the work activities to meet established schedules, deadlines and goals to include, but not limited to the following: billing, accounts receivable management, cash applications, denials and appeals, third-party payment variances, training and quality assurance and customer service. Reviews and maintains existing departmental policies and procedures, adjusting them as needed to support regulatory compliance.
Serves as an agent for change by challenging traditional practices and actively pursuing positive change. Identifies new opportunities and champions new initiatives. Takes unpopular stands when necessary to pursue progressive changes. Demonstrates the ability to persuade and effectively influence others. Adapts personal strategies/methods to achieve desired results. Demonstrates flexibility, versatility, and balance.
Establishes accountability in all areas of the accounts receivable ensuring all billing, follow up, denial and appeal activities occur timely.
Analyzes trends in accounts receivable, work queues and watchlists to identify performance gaps and implement solutions to improve cash collections. Serves as report expert for Experian power reporting. Publishes monthly report to improve first pass yield and denials.
Serves as the expert for the No Surprise Act to ensure compliance with the Delaware and Federal regulation. Publishes monthly report on out of network plan reimbursement at the employer level.
Participates in payer meetings and escalates issues to the appropriate agency when payers are not compliant with Delaware regulation or CMS policy related to prompt payment, record request review and interest payments. Participates in charge master meetings representing Patient Financial Services and the Revenue Cycle. Reports back to the department identifying impacts to current processes.
Conducts monthly vendor meetings holding them accountable for performance. Ensures responds timely to vendor needs in support of their performance efforts. Reviews monthly invoices for accuracy.
Focuses on cost control and reduction related to all departmental expenses.
Education: Master Degree; Health Care ; or Master’s degree in Management, Business, Finance, or Accounting
5 years’ experience in manager role of hospital Patient Financial Services or equivalent experience as a revenue cycle consultant specific to Patient Financial Services.