Director of Patient Financial Services - 40hrs/wk, Monday - Friday
Madonna Rehabilitation Hospital Lincoln, NE
Job Title: Director of Patient Financial Services Job Code: 880077
Immediate Supervisor: Administrator of Financial Services Status: Exempt
DEPARTMENT FUNCTION/JOB OVERVIEW
Responsible for overall operational management and supervision of Patient Financial Services functions and staff. Works with external payers to maximize appropriate reimbursement for each of Madonna's business lines. Responsible for management of the processes for professional fee coding for Physician Services billing. Responsible for management of all revenue cycle processes to include the processes for professional visits conducted by employed and contracted fee for service clinicians including professional fee coding, claim submission and revenue collection for those visits. Responsible for researching, recommending and implementing operational changes in order to enhance revenues and reduce cycle time for physician services in addition to all applicable Madonna business lines, including hospital and Long Term Care. Responsible for quality service delivery and internal/external customer relations for the department and Madonna Rehabilitation Hospital as a whole, including upholding the mission and values for the department and facility.
- Ensure maximum appropriate reimbursement for services provided by all Madonna business lines.
- Oversee design, implementation and monitoring of highly effective processes to achieve best practice levels in patient financial services management for all business lines and to produce accurate, timely data regarding performance and performance improvement.
- Identify opportunities and make recommendations regarding revenue cycle and reimbursement enhancements for all business lines.
- Oversee accurate patient billing and collections processes to ensure timely, accurate generation of claims and receivables.
- Oversee implementation and maintenance of processes which verify and analyze payments submitted by third party payers, governmental agencies and private payers for accuracy and timeliness.
- Manage and audit coding process to ensure proper charges for professional fee services and reimbursement.
- Implement processes to ensure departmental working knowledge of reimbursement for outpatient therapies, PPS hospitals, nursing homes (e.g., CPT and ICD9 coding) and rules and regulations of all pertinent regulatory agencies. Maintain regular communication with Medicare Administrative Contractor (MAC) and monitor regulatory and reimbursement changes to keep services performed by functions current with latest billing/ collections requirements, as well as for the development and expansion of services. Analyze and communicate reimbursement issues and regulatory changes and impacts to appropriate Madonna staff.
- Manage and audit billing and collection processes to ensure accurate processing of third party claims and expedite accurate, timely, maximum reimbursement.
- Analyze data from financial and practice management reports as required to manage department.
- Monitor governmental regulations and industry developments to maintain professional, managerial, business, technical and regulatory knowledge regarding patient account management and billing and collection functions.
- Develop and monitor key indicators to assess and effectively manage processes and tasks.
- Compile, analyze, compute and coordinate operational budget that reflects facility goals in order to maintain expenses within acceptable limits.
- Ensure documented processes are in place to continuously identify opportunities for revenue enhancement for all business lines.
- Ensure all applicable measurement systems produce accurate, timely data regarding performance and performance improvements.
- Ensure corrective actions are implemented which are highly effective in resolving problems/improving department or functional performance.
- Collaborate with and within the Customer Access System to ensure excellent service, achievement of CAS and facility goals, and compliance with regulations, policies and procedures.
- Supervise Patient Financial Services staff. Hire, orient, coach, and provide direction for staff for professional growth through regular performance management and timely completion of staff performance reviews.
- Monitor staff performance and department results as a whole, implement effective corrective actions and keep supervisor and others informed of significant information and events.
- Establish and implement goals and objectives for assigned functions to provide direction and effectively manage the functions to achieve excellent service and patient financial services management.
- Ensure excellent external and internal customer service supported by excellent systems and processes.
- Ensure supervisor and applicable Madonna leadership are informed of significant information and events.
- Follow instruction from supervisor to perform other functions as assigned in order to achieve the goals of Madonna.
- Maintain and ensure a safe and clean environment. Handle and operate all necessary equipment and perform required duties according to established safety standards to maintain compliance with regulation and prevent injury.
- Effectively and efficiently operate copier, telephone, calculator, fax machine and have proficient computer skills, including e-mail, word processing, presentation, spreadsheet functions (Excel), and patient accounting software.
PHYSICAL DEMANDS AND ENVIRONMENTAL CONDITIONS
Indoor sedentary work, including lifting and carrying. Some bending and balancing to read and file, frequent reaching and handling of paper. Requires sufficient sight to see and read reports and computer screen. Requires sufficient hearing and speaking to communicate by phone or in person.
QUALIFICATIONS (Education/training and/or Experience)
Completion of high school or equivalent required. Bachelorâ??s Degree in Business Administration, Finance or other analytical field required. Five years experience required in patient financial services/patient accounts/revenue cycle, which includes a minimum of two years of management. Demonstrated working knowledge of CPT and current ICD coding of Professional Fee visits required. Applicable work experience maybe considered in lieu of formal education as determined by Madonna. Excellent working knowledge of Medicare/Medicaid and insurance reimbursement regulations and requirements required. Demonstrated working knowledge and skills of billing processes required. Must possess excellent analytical and problem solving skills, as well as superior performance management and communication skills (verbal and written). Must have demonstrated experience working independently using critical assessment to prioritize responsibilities. Proficiency with Microsoft Office products preferred. Proficiency level knowledge of Excel required.
Background checks are conducted. When specific authorization forms are requested so that full background and history can be obtained, employees/applicants must sign the form(s) requested.
| Date Posted
December 15, 2018
| Date Closes
December 30, 2018
| Located In
Lincoln-Madonna Main Campus
| SOC Category
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