Director of Patient Financial Services in Florida, New York at Stratum Med

General Summary of Duties:
Directs the Patient Financial Services department to provide high quality medical coding, insurance billing, payment posting and customer service to patients, physicians and administrators through the establishment and execution of departmental goals and the efficient utilization of departmental human resources. Manages the departmental budget and practices effective fiscal management. Plans and controls the department functions and activities and directs workflow. Establishes quality and productivity standards of the department and monitors performance. Interprets practice policies and provides counsel and guidance to staff members.

Duties and Responsibilities:

• Manage Revenue Cycle which includes but is not limited to Front-End Operations, Charge Capture, Medical Coding, Claims Submission, Pay Adjudication, Payment Posting and A/R Collections.
• Maintain acceptable performance by established standards for Accounts Receivable, Days in A/R, Net practice revenue, collections, credit balance and gross charges.
• Develop and implement work quantity, KPI’s and quality standards for all work in progress. Also, provide Cross Training and Succession planning for all departments.
• Develop and maintain policies to ensure billing/Medical Coding compliance in accordance with State and Federal Health Care Regulatory Laws. Ensure that physician and staff training on medical coding is provided, updated and delivered timely.
• Safeguard practice funds. Analyze third-party payer reimbursement rates, set fees for practice self-pay services, oversee in-house audits of accounts for accuracy of medical coding, documentation payment posting and analyze claim denials.
• Prepare Department staffing and Capital expenditure budgets annually and practices effective fiscal management.
• Responsible for Department Managers’ development, training and performance
• Address the concerns, inquiries and requests of patients, physicians, Administration, Clinical Directors, PFS staff and others regarding Business Office related issues.
• Make recommendations to Administration, QIRM, Senior Management, Finance Committee and Board of Directors regarding PFS Department operations.
• Interprets practice policies and provides counsel and guidance to staff members.
• Adheres to guidelines set by the practice’s Compliance Program, following all Health Care Regulatory Laws on medical coding, billing and reporting of compliance issues. Maintains confidentiality of practice materials. Refrains from discussing or releasing confidential information except with individuals legally entitled to such information and as specifically authorized for release. Serves on the HIPAA and the Compliance Committees.

Knowledge, Skills and Abilities:

• Interpersonal Skills - Uses interpersonal skills effectively to build and maintain cooperative working relationships within the department and the practice. Demonstrates fact, courtesy, self-control and discretion in interactions with others and is regarded as a team player by co-workers and other departments.
• Customer Service – Demonstrates excellent customer service practices by greeting customers/patients in a friendly and courteous manner and offering assistance when needed. Is responsive to customer/patient needs, demonstrating sensitivity to individual special needs and cultural diversity. Highly supportive of other staff in accomplishing whatever needs to be done to serve the customer/patient.
• Management and Supervision – Consistently manages department and staff to insure appropriate staffing and skill levels to provide appropriate care/maintain operations. Selects, hires, orients, trains, direct, develop, disciplines and terminates employees as appropriate and in accordance with practice policy. Conducts employee reviews in a timely manner. Conducts regular staffs meetings and effectively communicates practice information, encourages staff input and discussion. Is a role model for work ethic and dependability.
• Department Operations – Maintains department operations within budgetary guidelines, reporting exceptions to supervisor. Implements practice policies and procedures as directed. Monitors employee productivity and maintains appropriate records of operations. Ensures proper resources are available for departmental efficiency, patient care, and expense reduction, making recommendations as appropriate. Compliance – Upholds all aspects of practice Standards of Conduct. Holds self to the highest standard of individual ethical and legal business practices and takes appropriate steps to identify, report and prevent illegal or unethical activity in the workplace.
• Communication Skills – Communicates thoughts and ideas clearly and demonstrates ability to listen and offer sound feedback. Is concise in both written and verbal communications. Keeps management and peers well informed. Can gather data and prepare effective reports.

QUALIFICATIONS:
Required:

• Bachelor’s degree in business administration or related field preferred.
• Minimum 5 years’ experience in healthcare field, including Business Office and Operations understanding.
• Preference given to those with EPIC experience and understanding of hospital and medical group financial models.
• Current knowledge of State and Federal laws and regulations, and other current events impacting practice.
• Excellent interpersonal and communication skills.
• Ability to work independently and exercise appropriate judgement.
• Analytical skills, professional appearance and manner.