ASSISTANT DIRECTOR PATIENT FINANCIAL SERVICES
Orange, California, United States
Hybrid Remote (Work from home 2-3 days a week)
125-170K Bonus Full Benefits (No Relocation)

Position Summary:
Responsible for planning, directing, and managing all aspects of Accounts Receivables management for the Patient Financial Services department; including commercial, managed care, workers compensation, ERISA, self-funded and all other indemnity health plans. Ensures standards of unit operations are in compliance with all state and federal healthcare regulatory agencies. Participates on organizational performance improvement projects. Analyze denial trends and publish organizational reports to improve first pass yield. Incumbent has overall responsibility for training, unit performance, resolution of operational and personnel issues, evaluations, hiring, and disciplinary action. Serves as a role model and resource to colleagues, staff, and others. Interacts with all levels within the organization, including senior leaders, managers, directors as well as insurance companies, third party payers, vendors, and regulatory agencies.

Required Qualifications:

• Ability to motivate staff to achieve desired results
• Sound understanding of Joint Commission and other applicable regulatory requirements to be able to monitor for compliance
• Ability to maintain a work pace appropriate to the workload
• Excellent written and verbal communication skills in English
• Demonstrated experience building competency and developing skills of others
• Must have experience in working with contracts, applying terms and conditions to claims and performing split billing as required by Contracted Payers and DOFRs.
• Working knowledge of billing commercial claims, workers compensation, managed care and all other third party payers.
• Detailed understanding of billing technical elements such as standard forms and data elements, coordination of benefit and third party liability billing and collection, electronic billing, data edit programs, reimbursement methodologies such as Diagnosis Related Groups (DRGs), Case Rate, Percent of Charges, capitation.
• Thorough knowledge of healthcare billing, finance and compliance and strong understanding of facility billing systems.
• Extensive knowledge of governmental compliance rules and issues as it pertains to health care billing, collection and other reimbursement.
• Self- directed and organized with superior analytical and problem-solving skills.
• Five (5) years' experience in a revenue based, health care related industry such as admissions, registration, billing/collections or contracting
• Five (5) years' experience in management of Patient Financial Services
• Experience in PFS Operations in an Academic Medical Center organization or complex teaching environment
• Working knowledge of billing, follow up and denial management of commercial claims, workers compensation, managed care and all other third party payers.
• Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
• Bachelor's Degree in related field

Preferred Qualifications:

• Master’s degree in Health Care Management, Business, Finance or Accounting
• Experience in PFS Operations, University and medical center organizations, policies, procedures and forms
• Prior management experience of union-represented staff
• Knowledge of University and medical center organizations, policies, procedures and forms