Mgr Patient Fin Services / Revenue Cycle presso Children's Hospital & Medical Center

At Children’s, the region’s only full-service pediatric healthcare center, our people make us the very best for kids. Come cultivate your passion, purpose and professional development in an environment of excellence and inclusion, where team members are supported and deeply valued. Opportunities for career growth abound as we grow our services and spaces, including the cutting-edge Hubbard Center for Children. Join our highly engaged, caring team—and join us in providing brighter, healthier tomorrows for the children we serve. Children's is committed to diversity and inclusion. We are an equal opportunity employer including veterans and people with disabilities.

A Brief Overview
The Manager of Patient Financial Services develops implements and controls policies and procedures directly related to the patient financial services for hospital service functions of billing, collecting, denials, and hospital and professional services function of cashiering, and customer service. Manages the activities of patient financial services staff and directs their efforts towards managing patient accounts to specific days in accounts receivables as well as the achievement of maximum reimbursement from all third party payors and guarantors for all services rendered. Oversees adherence to Children's established financial policies. Assists staff in daily operations as well as maintaining proper balance between customer service and the collection related activities.

Essential Functions

• Leads, plans and develops activities related to hospital service functions of , , billing, collections, denials and hospital and professional service functions of cashiering and customer service. Continuously monitors and implements sound business processes in an effort to maximize revenue for the organization. Evaluate vendor solutions such as collection agencies and early out programs, zero balance reviews, bad debt reviews etc. Defines operational standards, organizes departmental activities, and sets performance standards.
• Develops and maintains departmental policies, procedures, and objectives. Develops a control and review mechanism to ensure compliance. Ensures departmental compliance with Children’s policies and procedures. Synthesizes all available information to make informed decisions. Fosters creativity, innovation and divergent thinking in self and others. Manages complex situations using multiple sources of information and advice. Prioritizes, proposes and collaborates with Patient Registration, HIM, Children’s Physicians, Children’s Specialty Physicians, Financial Systems Manager and others in regards to operational projects and system changes based on careful analysis of current processes.
• Gains familiarity with the hospital and physician managed care contracts with respect to such administrative provisions as timely filing deadlines, clean claims payment windows, account audit timeframes, billing peculiarities and precertification requirements. Provides staff with the tools necessary to monitor payments in accordance with the allowables specified in the managed care contracts.
• Responsible for interviewing, selecting, rewarding, coaching, disciplining and terminating employees in the department to ensure proper functioning of the area. This includes working with the Financial Systems Manager to set performance-related criteria and standards as well as procedures for each incumbent in the department. Responsible for prompt completion of all performance evaluations and productivity statistics. Responsible for setting and monitoring departmental productivity standards as well as assuring the department's goals meet, or exceed, established standards. • Personnel Management ◦ Selects/hires employees and trains and/or oversees the training on job related tasks. ◦ Conducts employee performance management duties including completion and delivery of performance evaluations, setting goals, dissemination of information, coaching, addressing performance issues/routine correction actions, and recommending termination of employment. ◦ Makes salary recommendations. ◦ Submits notifications for personnel actions (e.g., status changes, terminations). ◦ Makes recommendations for human resource needs. • Operational/Financial Management ◦ Responsible for the implementation and execution of business plans or activities for the department. May assist in the development of business plans. ◦ Makes decisions guided by the business plan and resource availability that impacts service levels and the team’s ability to meet objectives. ◦ Analyzes processes and procedures and makes recommendations and/or decisions on guidelines for daily processes/activities within department. May recommend policy changes related to the department. Implements new or revised policies, processes, and procedures within the work area. ◦ Develops the annual budget, monitors and prepares budget variance reports for the department. ◦ Applies business and management expertise to identify problems/opportunities, determine solutions, and measure results. ◦ Ensures compliance with quality assurance, safety practices, policies, regulatory, and legal requirements.
• Reviews with the Financial Systems Manager the monthly departmental reports and jointly presents to Director of Revenue Cycle Operations. Monthly reports include but are not limited to budget variance reports, monthly accounts receivable reports including a review of the age trial balance, aging detail, longitudinal accounts receivable analysis, accounts receivable analysis by payor, employee and staff productivity reports and additional ad-hoc reports as required from time to time. Along with the Financial Systems Manager represents the hospital and physician billing departments at internal revenue cycle meetings and provider meetings. Stays abreast of changes in the industry by keeping current with CMS, Medicaid, HIPAA and payor billing regulations as well as market changes. Holds self accountable for professional development through active participation in HFMA, CHCA and other professional organizations.
• Along with the Financial Systems Manager represents the hospital and physician billing departments at internal revenue cycle meetings and provider meetings.
• Stays abreast of changes in the industry by keeping current with CMS, Medicaid, HIPAA and payor billing regulations as well as market changes. Holds self accountable for professional development through active participation in HFMA, CHCA and other professional organizations.
• Regular attendance at work is an essential function of the job.
• Perform physical requirements as described in the Physical Requirements section
• Primary back up for the Financial Systems Manager.

Education Qualifications

• Bachelor's Degree from an accredited college or university in business or health care required. Equivalent relevant work experience may be substituted for education. Required

Experience Qualifications

• Minimum 5 years’ experience in healthcare billing, healthcare collections, healthcare finance, healthcare registration, or healthcare IT Required and
• Minimum 1 year supervisory or lead experience Required

Skills and Abilities

• Possesses comprehensive knowledge of hospital and clinic revenue cycle operations
• Knowledge of hospital and physician billing, collection and reimbursement requirements and standard practice.
• Knowledge of the current healthcare climate, including managed care developments, HIPAA standards and governmental program regulations.
• Knowledge of CPT, HCPCS and revenue codes and their effect on hospital reimbursement.
• Ability to communicate effectively both verbally and in writing.
• Ability to pay close attention to detail and work with minimal supervision.

Children’s is the very best for kids and the very best for your career! At Children’s, we put YOU first so together, we can improve the life of every child!