Director Patient Financial Services

Oversee the formulation of provider contracts and all billing, collections, cash posting, and overall denials prevention.

• Ensures that provider contracts are processed to support accurate claims payments
• Ensures timely billing and follow-up is being executed by PFS staff
• Ensure that all revenue is being accounted for and charges rendered in a timely and accurate manner
• Assures contractual arrangements meet financial targets and legal/regulatory compliance requirements

Responsible for the operations of both PFS and Revenue Integrity (Charge and Reimbursement)

• Analyzes contract data and provides financial projections
• Provides input to strategic decisions that affect the functional area of responsibility
• Capable of resolving escalated issues arising from operations and requiring coordination with other departments
• Researching territories to identify gaps with our payer base and supporting the expansion into new markets
• Actively participate in establishing strategic business goals with the Leadership Team
• Develop and maintain periodic reports on the status of all contracts
• Assure accurate data entry of contract specifications and terms into database and completeness of all contracting processes

Responsible for developing and maintaining productive payer and internal stakeholder relationships

• Responsible for the accuracy of supporting documentation for contracts and completing documents accurately
• Ensure contractual language is kept current; evaluate fee schedule on a yearly basis to identify possible opportunities for additional covered services, medical policy changes and reimbursement.
• Maintain excellent written and verbal communication with all internal and external customers around denials, payer engagement/escalation, and cash intake/performance.
• Effectively and professionally represent Norman Regional Health System to provider community

Internal communication and education regarding payer contracts, denials, root causes, and effective billing and cash performance

• Collaborates with internal departments to ensure staff are informed of new contracts, changes to existing contracts, changes to existing contracts and updates to the medical and billing policies of the payers we service.
• Provide cost analysis and utilization data to support leadership decisions
• Develop and maintain processes that provide timely notification of critical events (renewals, terminations and due dates contained within the agreements)
• Coordinate and communicate contractual terms to the billing department; ensure staff is informed of changes in medical policy & billing policies.
• Assist with all contracting administration and projects, as needed.

OTHER FUNCTIONS

• Monitors and evaluates financial and productivity information to achieve operational benchmarks.
• Plans, analyzes and implements actions necessary to achieve established fiscal year department productivity benchmarks.
• Monitors progress of departmental operations, adjusting functions as necessary to achieve budget.
• Analyzes industry trends in the development of department operational needs.
• Collaborates with other departments to achieve organizational budget and revenue cycle benchmarks.
• Analyzes current operational functions and industry trends to validate benchmark targets. Defines and promotes new targets based on research and consideration of overall hospital operations.

Fosters the learning and development of staff to fulfill the current and future requirements of individuals and organization.

• Interviews, selects and hires the most appropriate job candidate. Seeks additional input from department members and delegates components of hiring process as appropriate
• Ensures department specific orientation, initial, and annual competencies are completed as per policy
• Clearly…