JOB DESCRIPTION

SHIFT :

Day (United States of America)

Seeking Breakthrough Makers

Children’s Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation.

At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families.

Join us as we build on our promise to advance pediatric care and your career.

CHOP’s Commitment to Diversity, Equity, and Inclusion

CHOP is committed to building an inclusive culture where employees feel a sense of belonging, connection, and community within their workplace.

We are a team dedicated to fostering an environment that allows for all to be their authentic selves. We are focused on attracting, cultivating, and retaining diverse talent who can help us deliver on our mission to be a world leader in the advancement of healthcare for children.

We strongly encourage all candidates of diverse backgrounds and lived experiences to apply.

A Brief Overview

Responsible for oversight of the Patient Financial Services Billing and Collection function for the Home Care Services including billing of claims through oversight of work assignments, communication with third party payors, analysis and resolution of billing, coding, denials and other issues.

Stays informed on current payer contracts, regulation changes, and other sources that impact reimbursement. Provide leadership in identifying and resolving payor collection issues Collaborates with Patient Access Services, Registration, Case Management / Utilization Review, HIM, Audit & Compliance, Revenue Integrity, and other Patient Financial Services leadership to assure smooth end-to-end processes, resulting in strong financial performance.

Collaborates with CHOP senior leadership team to assure the highest level of financial standards.

What you will do

• Provide leadership and strategic direction for the patient financial services function.
• Key partner to both the Senior Director of Home Care Services and Director of Specialty Pharmacy
• Collaborates with Home Care Patient Access, Financial Counselors, Case Management, Audit and Compliance, Department Clinical Teams, and other areas of Home Care and Specialized Pharmacy Services to ensure that revenue cycle flows efficiently and effectively.
• Monitors KPI performance against cash targets and develops strategies to achieve goals.
• Develops and maintains a high-performing team of revenue cycle professionals including but not limited to insurance verification, pre-registration, financial counseling, coding, billing, collections, denials / underpayments, customer service, and vendor management to drive improved financial performance at a lower cost-to-collect
• Performs various analytics to understand payor trends and collection performance
• Manages Revenue Cycle technology for Home Care and Specialized Pharmacy
• Updates and maintains payor contracts, credentialing, MAP reconciliations, and acts as administrator for all payor website resources.

Education Qualifications

• Bachelor's Degree Healthcare, Business Administration, or similar field of study. Required
• Master's Degree Healthcare, Business Administration, or similar field of study. Preferred

Experience Qualifications

• At least five (5) years Experience in Patient Financial Services billing / collections Required
• At least five (5) years Supervisory Experience Required

Skills and Abilities

• Superb leadership qualities; a consensus builder able to work both independently and collaboratively.
• Action oriented; proven track record of achieving agreed-upon goals.
• Facilitator with excellent presentation skills.
• Highly energetic with a collaborative style.
• Extremely skilled communicator with a style that engenders trust and accountability with those with whom he / she works.
• Thinks proactively and strategically with sound business and strategic planning skills.
• Ability to maneuver through complex political situations effectively and quietly; informal influence skills.
• Emphasizes team goals with a common purpose and seeks win-win solutions. Takes ownership for projects, programs and services, and accepts accountability for results.
• Strong sense of ethics consistent with those of The Children's Hospital of Philadelphia.
• Project management skills.
• Solid working knowledge of process innovation methodology.

Licenses and Certifications

• Certified Revenue Cycle Representative (CRCR) Healthcare Financial Management Association Preferred
• Hospital Business Institute (HBI) Certification Hospital Business Institute Preferred

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community.

As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must be fully vaccinated against COVID-19 and receive an annual influenza vaccine.

Employees may request exemptions for valid religious and medical reasons. Start dates may be delayed until candidates are immunized or exemption requests are reviewed.

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Last updated : 2024-06-05