Cambridge Health Alliance Looking for SR. DIRECTOR, PATIENT FINANCIAL SERVICES at Malden, MA Full Time

Job Purpose:

Under the direct leadership of the Chief Revenue Officer, the Senior Director, Patient Financial Services is responsible for overseeing all revenue cycle operations for Cambridge Health Alliance.

Job Duties:

• Provide leadership to individual managers of the revenue cycle teams including Professional Billing, Hospital Billing, and Cash Posting. Ensure teams have the tools and training to manage daily business unit operations, and to achieve defined key performance indicators. Assist managers in resolving complex issues as they arise, escalating to appropriate parties when necessary.
• Responsible for revenue cycle performance. Daily review and monitoring of overall AR position including KPIs, work queue volumes, and performance of identified SWAT issues.
• Responsible for statistical and financial reporting necessary to monitor operations. Provide analysis of cash, outstanding AR, CFBs, adjustments, and denials to CHA financial and operational leadership weekly.
• Develop and manage annual department operating and capital budgets. Responsible for the financial performance of PFS.
• Oversee and monitor department goals and objectives, including individual goals for direct reports. Ensure goals are driven to support the health system s mission and vision.
• Work collaboratively with CHA financial and operational leadership as well as other departmental leaders to facilitate information sharing, problem solving, and new program development.
• Approve documentation of all department policies, procedures and workflow processes. Assist with the implementation of system changes to enhance workflow and process as necessary.
• Lead Denial Management Team, facilitating meetings with appropriate teams to decrease denials and continuously assess denial issues. Ensure all team members remain engaged and focused on denial resolution.
• Manage credit and collection activity to ensure that CHA s credit and collection policy and procedures are being followed. Evaluate and initiate new procedures to protect the hospital’s financial interest in securing payment while maintaining goodwill. Maintain current up-to-date information regarding third party billing requirements, third party reimbursement, government regulations, hospital contracts, and industry trends.
• Oversee all revenue cycle vendor and contractor performance, ensuring all persons working on behalf of CHA are doing so following CHA policies and procedures.
• Collaborate with external peers and professional groups to keep up to date on regional and national healthcare revenue cycle topics.
• Create an environment that promotes workforce recruitment, retention and development and maintains quality services.
• Monitor vendor and contractor performance and approve accounts payable invoices for payment.
• Oversee special project work as identified by SWAT or other teams to drive issue resolution related to billing/collections.

Qualifications:

• Master s Degree in finance, business administration or related field preferred.
• Ten years experience in revenue cycle management including five plus years of experience managing staff and operations.
• Demonstrated comprehensive and thorough knowledge of all third party rules and requirements as they relate to billing and payments.
• Working knowledge of CPT and ICD10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes.
• Demonstrated experience in the automation of patient accounts billing system activities.
• EPIC experience preferred.
• Demonstrated ability to establish a professional code and work environment and experience in working with clinical, ancillary department and primary care leaders to resolve problems.
• Demonstrated goal-oriented thinking, leadership ability, and strong interpersonal, operational and organizational skills.

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