Education: Bachelor's degree is required; Master’s level degree is preferred. Equivalent in work experience will be considered.
Training and Experience: A minimum of 5 years of experience as a team leader in the healthcare receivables field required, with a work record that demonstrates:
- Knowledge of industry best practices hospital and physician billing and reimbursement
- Leadership in the core values of the organization
- Clear, effective communication skills
- Proficient with Microsoft Office products
- A mature approach to problem-solving for all types of issues
- Skills in using mainframe and PC computers
- Knowledge of medical terminology
- Negotiating skills
- Detail orientation
- Experience with total quality management concepts and tools
- Knowledge of healthcare industry financial statistical indicators
- Meditech Expanse experience preferred
Job Duties:
- Provides leadership to ensure timely, efficient, and accurate submission of billing claims for government and managed care payers
- Develop procedures/plans to ensure staff handles all patient accounts according to procedures and ensures productivity targets are met
- Direct all activities for assigned revenue cycle areas, ensuring optimal revenue collection and patient satisfaction with the billing experience
- Responsible for designing, developing, and monitoring performance improvement processes both internally and externally with vendor partnerships
Safety Sensitive: NO
In the interest of protecting the health and safety of all patients, associates, and guests, Unity Health has classified some positions as “safety sensitive.” A “safety sensitive” position is any job position in which impaired performance could result in harm to the health and/or safety of self or others. Any associate that is actively engaged in the use of medical marijuana, even if in possession of a valid medical marijuana card, will be excluded from employment in a “safety sensitive” position.
DESCRIPTION:
The Patient Financial Services (PFS) Director will be responsible for, but not limited to, the day-to-day operations of the Patient Financial Services department including billing, collection, and supervision and training of personnel.
The PFS Director oversees the receivables management functions for respective work groups through accurate and timely billing and collection follow-up of patient accounts. Ensures timely submission and adjudication of all claims submitted to third party carriers/intermediaries and timely response to all inquiries according to Unity Health policies and procedures. Ensures reimbursement according to policy, state and federal regulations, and specific payer negotiated requirements. Supervises the operations and staff of assigned PFS functional areas. Prioritizes and coordinates patient account flow in all functional areas. Develops policies and procedures for assigned PFS functional areas. Oversees quality assurance and process improvement activities. Manages employee performance to meet or exceed quality and productivity standards. Performs performance appraisal and corrective actions. Maintains excellent working relationships with interdepartmental peers, community providers and staff.
The PFS director is highly skilled and works at a cross-functional level in the following areas:
- Bill and Claim Submission
- Cashiering, Refunds and Adjustments
- Customer Service
- Denial Prevention and Management
- Third Party and Guarantor Follow-Up
Physical Effort: Sitting 3-4 hours; standing 3-4 hours; walking 3-4 hours. Moderate lifting of 20-25 pounds, 1-10 times per day. Moderate bending, squatting and kneeling. Frequent fine motor movement with both hands. Manual dexterity to utilize computer. Good visual and hearing discrimination. Moderate lack of control over pace of work and high level of interaction with patients and employees throughout the workday.
Mental Effort:
- Ability to respond to sensitive inquiries or complaints from patients
- Ability to respond and communicate with regulatory agencies and the community at large
- Strong oral and written communication skills; able to write persuasive correspondence
- Ability to develop and present information at staff and leadership meetings
- Ability to define problems and problem solve
- Data oriented
- Clear logical thinking; ability to establish facts, collect data, and draw valid conclusions
- Abstract and concrete thinking skills
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