Works under the direction of the Director, Patient Financial Services while overseeing one or departments under the area of management. Responsible for displaying behavior that promotes accountability for performance of job tasks, which will meet or exceed the customers expectations. Ensure a positive work environment, acting as a resource to staff, in performing their job responsibilities. Ensures that staff is provided with training, support, and oversight that will enable EMC to collect accounts receivable on a timely basis and in compliance with all regulatory and intermediary requirements. Oversee and direct the Billing and Collections of all accounts with an insurance or patient balance due, Customer Service, Credit Balance review and Cash Posting. Will monitor the performance of all assigned staff and assist the staff as needed to promote timely resolution of the accounts receivable. Provide for training of new procedures and remedial training on processes as required by individual staff. Meets with staff on a regular basis to discuss issues and to identify those areas that are not meeting standards. Cultivate a spirit of teamwork within the work unit and with other departments to promote a positive, highly motivated team that will be able to reduce and maintain the average number of days in Accounts Receivable.
Develops, implements and coordinates the Oncology Service line including but not limited to budget, charge capture, authorizations and cost to collection analysis. Contribute to the development and implementation of short and long term strategies for service line growth and stabilization of current services and providers.
Additionally, will reduce and maintain the number of accounts rolling beyond 90 days old. Ensure that claims are compliant with regulatory guidelines and that follow-up activity occurs consistently on a daily basis and in accordance with written guidelines; work to provide excellent customer service; ensure timely posting of insurance and patient payments, and resolution of credit balance accounts. Assist in the development of departmental policies to ensure that procedures are in compliance with State and Federal Regulations, Joint Commission Standards as well as maintaining consistency with Eisenhower Medical Center policies and mission statement. Help to ensure the budgetary compliance of the Patient Financial Services Department.
Director, Patient Financial Services
Patient Financial Services Staff
Ages of Patients
Blood Borne Pathogens
Minimal/ No Potential
Required: BS/BA in related field or 10 years in a Mgr/Dir position in a healthcare setting may be substituted for degree
Required: 7+ years in a leadership role in a hospital PFS, Collection Agency or Payer setting. Basic medical & managed care terminology, CPT and ICD9 coding as well as accounting principles.
Preferred: Prior customer service.
Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
Ensure that procedures are followed to promote accurate and timely account resolution of all 3rd party claims.
Serve as Managed Care Liaison.
Receive telephone calls and respond to customer billing questions.
Maintain daily productivity logs for each member of the Patient Accounting Reps staff, providing them with weekly data on their successes and identifying any areas of needed improvement.
Participate in the interview and hiring process to ensure adequate PFS staffing.
Direct the resolution of account variances.
Assist in training sessions for all PFS billing staff.
Complete evaluation process for PFS billing staff.
Review and approve all manual adjustments and forward to Director if adjustment is greater than $2,500.00
Perform Quality Assurance audits on Patient Account Reps’ follow-up on a daily basis and provide feedback to each Rep regarding the audits.
Maintain production stats and implement corrective measures when production standards are not met.
Provide weekly production reports to Director for both auditing and collections.
Arrange for desk coverage when an employee is absent more than one day.
Conduct monthly staff meeting to provide feedback on unit operations, discuss problematic issues and introduce new procedures and/or regulations.
Identify problems and recommend procedural changes when appropriate.
Assist in the development of PFS policies and procedures.
Perform special projects and attend meetings as requested by Director.
Provide for regular and ongoing staff training as needed by individual staff and on a routine and ongoing basis to ensure optimal skill levels and a current knowledge base for all employees.
Maintain staff time and attendance records as required.
Recruit and screen new hire applicants and participate in selection and hiring process.
Counsel staff regarding performance deficiencies and give verbal and written disciplinary warnings under the direction of the Director.
Attends staff meeting, in-house training and attend classes pertaining to Federal and State billing regulations as well as compliance issues and Guidelines, when requested.
Perform other job-related tasks as assigned by Director.
Oncology Billing and Collections Specific:
Analyze service line profitability for Oncology departments.
Develop and maintain a pre authorization process/department for the service line ensuring that all services are authorized prior to treatment.
Manage pre-authorization and registration staff for all oncology services.
Coordinate the charge capture process for all areas of oncology and infectious disease ensuring accurate and timely billing of all services.
Coordinates with Service line Leadership in the development of departmental goals and objectives. Assists with the establishing, implementing and maintaining of nonclinical policies and procedures for the department.
Coordinates with Service line leadership and integrates services with this service line and other related departments and hospital services as needed.
Analyzes pharmaceutical product use and compares cost to reimbursement Provides monthly reports by Financial Class and high dollar and outlines concerns and/or opportunities.
Coordinates with Service Line Leadership to establish goals and objectives for non-clinical areas.
Oversees Managed Care relations relative to preauthorization and referrals. Interface with operational staff of managed care to trouble shoot and resolve issues as they arise.
Cross trains with and provides back up support to clinic support service areas as needed.
Monitor and enhance referring physicians’ satisfaction with the Oncology Service line as directed.