- Department: Revenue Cycle Management
- Schedule: Monday-Friday 9-5
- Hospital: Witham Health Services
- Location: 2605 N Lebanon St, Lebanon, IN 46052 (South Pavillion)
Job Summary:Directs all Patient Financial Services operations including billing, collections, cash posting, denial management, customer service, and self-pay programs. Owns the department's financial performance metrics and is accountable for meeting established targets for AR days, cash collections, denial write-off rates, and clean claim rates. Manages staff, vendors, and cross-departmental relationships; surfaces issues and solutions proactively to the Executive Director of Revenue Cycle. This is a hands-on leadership role requiring equal comfort with data analysis and people management.
Minimum Requirements:Required:- Bachelor's degree in Healthcare Administration, Business, Finance, or related field
- Working knowledge of CPT, ICD-10, HCPCS, revenue codes, APCs, DRGs, and payer reimbursement methodologies
- Minimum five (5) years of progressive healthcare revenue cycle experience, including at least three (3) years in a supervisory or management role in a hospital business office setting
- Direct experience with hospital billing and collections for Medicare, Medicaid, managed care, and commercial payers
- Demonstrated experience managing accounts receivable performance to specific benchmarks
- Proficiency in Excel and comfort with data analysis tools
Preferred:- Experience with Meditech EHR (Expanse preferred) and Waystar or comparable clearinghouse/RCM platform
- Experience with revenue cycle automation or predictive denial analytics tools
Continuing Education:This position requires ongoing continuing education in Medicare, Medicaid, and commercial insurance billing; federal and state revenue cycle compliance (price transparency, No Surprises Act, 501(r)); and revenue cycle leadership and analytics.
Required Competencies:This position requires the following skills and abilities:
- Independently analyzes AR, cash, denial, and write-off data to identify trends, root causes, and opportunities; translates findings into actionable recommendations with dollar impact and defined next steps
- Produces monthly financial and operational reports for executive leadership
- Manages staff performance through quality audits, timely evaluations, and structured coaching; addresses performance and conduct issues promptly and directly
- Works independently to maintain the department's operational rhythm; communicates status, risks, and progress proactively
- Deep understanding of the full revenue cycle from patient access through final resolution
- Working knowledge of federal and state billing regulations: Medicare/Medicaid compliance, HIPAA, No Surprises Act, and 501(r)
- Maintains confidentiality of all patient and financial information
- Maintains composure under pressure; represents the department professionally to physicians, executives, board members, and patients
- Exemplifies excellent guest relations with patients, staff, physicians, and the public
Essential Functions:A.Financial Performance and Data Analysis- Maintains hospital and professional AR days at or below benchmark targets; monitors daily and acts when trends move in the wrong direction
- Produces monthly performance reports covering AR days and aging, cash collections vs. budget, denial rates and write-off categories, clean claim rate, and unbilled AR; delivers to the Executive Director on an established schedule
- Conducts root cause analysis on any metric that misses target: dollar impact, affected population, contributing factors, and corrective action plan with timeline
- Monitors daily cash posting and investigates variances; tracks credit balances and ensures refunds are processed within regulatory timelines
B.Denial Management- Owns denial management end to end: tracks and trends denials by payer, reason code, and dollar amount; oversees appeals and outcomes; reports results monthly; and drives cross-departmental root cause resolution with Patient Access, Coding, and clinical departments
- Reduces preventable denials through process improvement and staff education; routes clinical denials (medical necessity, level of care) to staff with appropriate clinical/appeal expertise
C.Billing Operations, Vendor Management, and Compliance- Ensures timely and accurate claim submission for all payer types; monitors clean claim rate and addresses root causes of claim rejections
- Manages all PFS vendor relationships: AR follow-up vendors, collection agencies, clearinghouse/RCM platform, and patient statement and payment portal vendors; reviews invoices and manages contracts through renewal/termination cycles
- Maintains compliance with all federal, state, and payer-specific billing regulations; develops, maintains, and enforces department policies and procedures
- Owns price transparency compliance (machine-readable file and shoppable services tool), No Surprises Act compliance (Good Faith Estimates, dispute resolution readiness), and 501(r) compliance for the billing and collections side
- Manages the patient billing and statement process, including customer service for billing inquiries and payment plan administration
D.Staff Management and Quality Oversight- Directly supervises PFS managers, supervisors, and/or team leads; indirectly oversees all PFS staff
- Conducts monthly quality audits: reviews a defined sample of accounts per collector to assess note quality, follow-up appropriateness, and protocol adherence; documents results and provides feedback
- Manages the worklist system: ensures accounts are distributed equitably, queues are current, and no account goes unworked past established thresholds
- Completes performance evaluations on time with specific, measurable feedback; creates and follows through on performance improvement plans when warranted
- Develops staff through ongoing training, cross-training, and professional development planning; identifies succession risks
E.Patient Financial Experience and Technology- Owns the patient financial experience: pre-service cost estimates, clear statements, and responsive billing customer service; ensures financial counseling and charity screening are offered consistently before accounts move to collections
- Identifies and sponsors automation and technology opportunities across PFS; governs revenue cycle tools for accuracy, compliance, and measurable return
F.Communication, Collaboration and Administration- Communicates proactively with the Executive Director on department status, risks, wins, and needs; represents PFS in cross-departmental meetings
- Resolves patient, physician, and interdepartmental complaints professionally and promptly
- Participates in budget development; manages department expenses within approved budget
- Supports hospital mission, values, and strategic plan; maintains 24-hour accountability for department operations
- Ensures a safe, respectful, and professional work environment in compliance with infection control, hazardous materials, disaster/fire safety, and general safety policies
- Additional duties as assigned
Accountability for Performance Metrics:This role is accountable for maintaining revenue cycle performance metrics at or above established targets.
