Director, Patient Financial Services (PFS) - Healthcare CBO

Job Title: Patient Financial Services Director (Hospital Revenue Cycle)

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.

Key Responsibilities:

• 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.

Requirements:

• Requires a Bachelors Degree and a minimum 12 years of prior relevant experience or Associates 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.

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.

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.

Salary Range:

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.