Alameda Health System is the East Bay's premier patient and family-centered care system. Our trauma center and teaching hospital are considered among the best in the country. We are committed to continually improving health through individual patient experiences. Our mission, Caring, Healing, Teaching, Serving All, speaks to the vital role we play in the community and the critical responsibility we accept in promoting wellness, eliminating disparities and optimizing the health of a diverse East Bay.
As the Director, Patient Financial Services, you will provide leadership to the areas of patient billing, collections, denials and underpayment, correspondence and collections for the Alameda Health System.
- Assists in ensuring appropriate implementation of revenue integrity policies and procedures that include daily charge reconciliation and capture, compliant charging, coding and documentation, and the performance of routine audits to ensure that system interfaces are working properly.
- Assists in periodic audits by state, county, external and third-party contracted auditors or fiscal intermediaries. Ensures that billing and collection activities are compliant with current county, state and federal regulations.
- Defines and meets revenue cycle performance goals and metrics. Evaluates the performance and effectiveness of management and staff related to the revenue cycle metrics and works to continuously improve performance, outcomes and maximize cash collections.
- Evaluates the performance of subordinate management, develops staff and management skills, sets goals and objectives, and performs ongoing evaluation of departmental operations to ensure maximum efficiency and effectiveness.
- Allows documented standards and practices to ensure timely and accurate cash posting and application of accounts receivables adjustments, write-offs and account transfers. Approves write-off, adjustments and refunds within limits of AHS policy.
- Maintains appropriate programs and infra-structure to ensure a high level of customer satisfaction that includes patient friendly billing techniques, prompt service recovery and creation of an ideal patient experience. Investigates and promptly resolves patient problems or reported service dissatisfaction.
- Maintains appropriate programs and infra-structure to ensure a high level of employee engagement and satisfaction. Meets engagement score targets as measured by employee engagement surveys.
- Manages and meets the operating and capital budgets for assigned areas. Prepares departmental financial, operating and performance variance reports, and maintains internal policies and procedures.
- Recommends and facilitates the implementation of new and updated information systems specific to the needs of the revenue cycle; identifies and communicates system problems, enhancements, upgrades to all relevant staff and departments; develops partnerships with vendors to ensure the incorporation of best practices and maximization of current information system applications.
- Stay abreast of changing government billing regulations, new programs and revenue opportunities. Ensures that managers, supervisors, staff and billing vendors are current with required codes, bill forms, electronic claims processing tools and documentation rules.
- Through subordinate managers and supervisors, oversees and directs patient billing and collection activities including accounts receivable management, third party payer follow-up, claim submission, third party vendor management, appeals, and payment posting.
- Understands and applies third party payor contracting terms, oversees claims editing system edits and rules, monitors actual payments and denials against contractual terms and works with payers to reconcile under or over payments.
- Works with clinical departments and revenue enhancement staff to ensure compliance with all supporting documentation necessary for successful claims submission and reimbursement.
- Works with Patient Access, HIM, IT, clinical and otherrevenue enhancing departments to ensure compliance with all supporting documentation necessary for successful claims submission and reimbursement.
Education: Bachelor's degree in business or health care administration with major emphasis in accounting, finance, economics or closely related field preferred.
Experience: Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying. At least two years of progressively responsible management experience and experience in contracting, revenue cycle or charge description master in a large healthcare organization is highly desired.