The Senior Director of Patient Financial Services is expected to demonstrate, through plans and actions, a consistent standard of excellence to which all departmental work is expected to conform. Such a standard should be based on establishing and maintaining a constancy of purpose, focusing on continuous improvement within the Directors area of influence, and delivering the highest degree of quality service possible. Critical responsibilities include achievement of annual and periodic goals for significant statistical indicators for CMGs revenue cycle and patient account performance. The Director leads the organizational effort to optimize the performance of all components of patient access, scheduling, claims management and professional code auditing in all aligned medical practices. This includes all applicable elements of the patient encounter, all elements of the billing and collection cycle, appropriate areas of compliance, optimal use of available software, and management of any associated outside vendors. The Revenue Cycle Director identifies opportunities for improvement and manages the implementation of solutions.
Complete various financial forecasts, including any long-range strategic plans for the department
Maintain appropriate internal control safeguards over AR records and collection of cash
Directs insurance processors and customer service representatives daily operational tasks
Ensures claims denials and rejections are logged for measurement and analysis
Ensure compliance with relevant regulations, standards, and directives
Reviews and understands regulatory billing updates
Chart process workflow
Plays an integral role in the implementation and installation of new systems and related processes
Completes random account audits weekly to identify opportunities for improvement
Collaborates with patient access to improve accounts receivable performance
Addresses medical necessity denials, authorization denials and accuracy of demographic and insurance information
Audits clinical documentation for CPT/HCPCS coding
Ensures accuracy of ICD-10 in the practice setting
Manages the claims appeal process
Maintains efficient and effective workflow in the central billing office and the revenue cycle components of all medical practice sites
Interprets complex contractual arrangements
Optimizes revenue of managed care within varied contract structures
Analyzes data, determines trends, utilizes statistical principles, and conveys financial projections for CMG
Develops the annual budget for the central billing office. Contributes to the development of the annual budget for each practice site and the Medical Group
Monitors budget variance for the central billing office
Works with Finance to assure accurate and timely reconciliation of all monies
May perform other duties as assigned or requested and job specification can be modified or updated at any time
Required Education: Bachelors Degree or in lieu of a minimum of ten (10) years of healthcare revenue cycle experience
Preferred Education: Masters Degree
Required Experience: Has a thorough understanding of coding methods, including CPT, ICD, and HCPCS. Able to work in a complex and changing environment. Three or more (3+) years of medical billing experience. Five or more (5+) years in a professional medical services area such as a medical office or out-patient department. Three or more (3+) years of experience managing staff
Salary Range: $125,685.00 - $201,097.00
