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Guidehouse · 1 day ago

Director, Patient Financial Services (PFS) - Healthcare CBO

US - CA, El Segundo

Full-time

Onsite

Director/Executive

$130K/yr - $216K/yr

12+ years exp

Guidehouse is a company specializing in managed services, and they are seeking a Director for their Patient Financial Services department. The role involves managing hospital client operations, focusing on revenue cycle activities, billing, and compliance with payer regulations.

AdviceConsultingManagement Consulting

H1B Sponsor Likely

Responsibilities

The Patient Financial Services Director (Hospital Revenue Cycle) is responsible for the overall management of the Hospital Client PFS department operations, including patient accounting, credit and collections, denial management, and other related key revenue cycle activities

Leverage extensive experience with healthcare hospital billing systems including electronic claims and authorizations, to maximize revenue and cash flows

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

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

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

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

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

Seeks out opportunities for individual growth and development, including attending various meetings, conferences, and courses, as required

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

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

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 company policies and procedures

Verify and monitor time off requests

Able to fill in for Managers

Qualification

Healthcare billing systemsRevenue cycle managementBillingCoding regulationsFinancial systems understandingHFMA MAP metricsAnalytical skillsMultitaskCommunication skillsInterpersonal skills

Required

Requires a Bachelor's Degree and a minimum 12 years of prior relevant experience or Associate's Degree and a minimum 14 years of prior relevant experience

Relevant experience coming from a healthcare provider, payor, CBO, business office environment or an outsourcing company