Summary/Objective

The Administrative Director of Patient Financial Services provides strategic and operational leadership for the Hospital's post-service revenue cycle and Patient Financial Services functions, including, but not limited to, hospital billing, collections, denial management, payment posting, cash reconciliation, credit balances, and refunds. Provides Patient Financial Services support for Baptist Hospitals of Southeast Texas and supports another hospital in the system. Assists the Chief Financial Officer with various projects, as needed. The Administrative Director is responsible for optimizing reimbursement and cash flow, managing departmental performance and resources, maintaining effective internal controls, and ensuring compliance with applicable regulatory and payer requirements. The position provides oversight of Business Services systems, workflows, reporting, and third-party services; leads process improvement initiatives; develops and supports staff; and collaborates with Hospital leadership and key departments to resolve issues affecting billing, reimbursement, and overall revenue-cycle performance.

Essential Job Duties

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Directs the day-to-day operations of Hospital Business Services/Patient Financial Services. Plans, directs, and oversees hospital billing, insurance accounts receivable and collections, denial and rejection resolution, payment and adjustment posting, cash reconciliation, credit balances and refunds, and other assigned functions. Establishes workflows, internal controls, staffing and performance expectations to ensure accurate, timely account resolution and reimbursement.
2. Maintains and provides operational oversight of patient accounting, billing, and revenue-cycle systems. Maintains the Hospital's patient accounting and billing systems, including system configuration, billing requirements, edits, work queues, reports, and other operational changes necessary to support accurate and timely billing and account resolution. Oversees related interfaces, clearinghouse functions, payer platforms, and revenue-cycle applications, and partners with Information Technology, Finance, vendors, and other departments to troubleshoot system issues, test and implement changes, and maintain effective system workflows and data integrity.
3. Directs accounts receivable, denial management, billing, and collection performance to optimize reimbursement and cash flow. Monitors key revenue-cycle performance indicators, including accounts receivable aging, cash collections, unbilled accounts, claim rejections, denials, underpayments, credit balances, timely filing, productivity, and account inventories. Identifies trends and root causes and leads corrective actions in collaboration with appropriate departments, payers, and vendors.
4. Ensures compliance with hospital policies and applicable billing and regulatory requirements. Develops, maintains, and monitors Business Services policies, procedures, and internal controls. Ensures compliance with applicable federal and state regulations, Medicare and Medicaid requirements, commercial and managed-care payer guidelines, and Hospital policies. Evaluates regulatory and payer changes, implements necessary operational changes, and supports internal and external audits.
5. Provides financial stewardship and manages departmental resources, budgets, and vendors. Develops and manages the departmental operating budget and monitors staffing, productivity, expenses, hour/stat, cost/stat, and other financial and operational targets. Oversees applicable third-party vendors and identifies opportunities to improve efficiency, control costs, and maximize appropriate reimbursement.
6. Leads and develops the Business Services team and advances organizational objectives. Establishes departmental goals, performance standards, productivity and quality expectations, and accountability consistent with Hospital objectives and BHSET Behavioral Expectations. Recruits, develops, coaches, and evaluates staff; promotes training and continuous improvement; and collaborates across departments to improve revenue-cycle performance.

Required Education and Experience

Bachelor's degree in related field.

5 years of leadership experience in hospital revenue-cycle, patient financial services, or hospital business office experience including hospital billing, accounts receivable, collections, payment posting and/or denial management.

Required License/Certifications

N/A