Navigant Cymetrix unites the strengths of four category-leading companies to address the complexities of today’s healthcare system. We design, develop and implement integrated, patient-centered solutions for sustained improvements in performance and profitability, working collaboratively across a spectrum of customers that encompasses hospitals, health systems, physician practice groups and payers.
Reporting to the Vice President, Operations, the Patient Financial Services Senior Director is responsible for the overall management of the PFS department operations, including patient accounting, collections, denial management, and other related key revenue cycle activities. The Senior Director will define and achieve departmental key performance indicators, objectives, manage billing, follow-up and denials of patient accounts, compliance with third party payer regulations, and work with company resources to assure ongoing improvements to key revenue cycle indicators.
Duties and Responsibilities
- Comprehensive knowledge of healthcare, billing, finance and accounting principles
- Detailed knowledge and understanding of billing technical elements, such as standard forms and data, coordination of benefits, third party liability, billing and collection, CPT, ICD-10, EDI, data edit programs, reimbursement methodologies such as DRGs, APCs, ASCs, EAPG, etc.….
- Excellent verbal and written communication skills
- Comprehensive knowledge of HFMA MAP metrics
- Ability to review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
- Upon identification of issues, researches issue to determine whether it is an isolated instance or a trend and follows up the appropriate Revenue Cycle leadership to facilitate communication and resolution of the issues
- Strong attention to details and accuracy, using problem-solving skills and analytical thinking
- Ability to successfully prioritize and manage numerous tasks simultaneously
- Establishes and develops collaborative relationships with other leaders in the Revenue Cycle
- Works with Managed Care Department for Underpayment Analysis
- Works with team to research and resolve denials
- Attends and participates in committees and task forces as assigned
- Prepares materials for and with experience conducts and chairs project meetings.
- Maintains current knowledge of regulatory standards, which may impact utilization of processes and systems.
- Maintains strict confidentiality of all patient, employee and physician information.
- Seeks out opportunities for individual growth and development, including attending various meetings, conferences, and courses, as required.
- Uses tact and sensitivity when communicating with patients, visitors, co-workers, and other Health System personnel.
- Participates in the development of PFS policies and procedures.
- Serves on department and/or institutional committees as requested.
- Leverage extensive experience with healthcare hospital billing systems including electronic claims and authorizations, to maximize revenue and cash flows.
- Collaborate, mediate, and resolve applicable items/issues between Finance and Hospital PFS
- Possess skills in order to understand financial systems and patient accounts and ability to detect and resolve problems related to Accounts Receivable
- Ensure compliance with relevant regulations and standards pertaining to Hospital PFS
- Possess a demonstrated knowledge of process improvement techniques and their application
- Demonstrates an ability to plan, coordinate, implement and control Hospital Billing and Collection services and to function effectively in a management position in a complex centralized environment.
- Manage outpatient registration, emergency registration, admitting and cash application.
- Leverage extensive knowledge of front and back end billing operations.
- Demonstrate knowledge of billing and coding regulations.
- Demonstrate proficiency with registration, eligibility, and third party verification, billing and collections.
- Extensive experience with healthcare hospital billing systems including electronic claims and authorizations, to maximize revenue and cash flows.
- Performs all other job functions related to this job.
- Hire, review, discipline and separate employment
- Monitor and report daily/monthly productivity
- Ensure Team Member compliance with Navigant Cymetrix policies and procedures
- Compile and forward Team Member timesheets to Navigant Cymetrix payroll for processing
- Verify and monitor time off requests
- Able to fill in for Managers
- A minimum of 10-15years of progressive hospital patient financialexperienceand has held a Leadership role (Director/ Sr. Director or above)
- Bachelor’s Degreerequired with an emphasis in finance or accounting preferred.
- Will consider a combination of relevant education and additional experience.
- Membership and/or certification from HFMApreferred
- Must have a solid understanding of Healthcare Revenue Cycle, payer contracts and regulation affecting reimbursement for healthcare services.
- Excellent verbal, written, analytical and interpersonal skills.
- Flexibility and ability to handle multiple concurrent activities and change.
- Team player and able to work with many people effectively.
- Ability to work independently and meet deadline constraints.
- Physical ability to bend, stoop, stretch and push.
- Hearing acuity, visual acuity and visual color distinction.
- Some travelrequired.
- Strong conceptual, as well as quantitative and qualitative analytical skills
- Work as a member of a team as well as be a self-motivator with ability to work independently
- Constantly operates a computer and other office equipment to coordinate work
- Frequently travels by airplane, train or car as necessary to perform work at anotherlocation
- Regularly uses close visual acuity and operates computer equipment to prepare and analyze and transmit data
- Generally works in an office environment
Navigant Cymetrix is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information or any other basis protected by law, ordinance, or regulation.