Director Patient Financial Services

Job Summary: To provide leadership and professional management skills in the capture, management, and collection of patient service revenue. Duties include monitoring and enhancing an effective revenue cycle process throughout the organization with a focus on aligning operations while maintaining effective human resource management. Director of Patient Financial Services contributes to the success of JCMH and is responsible for helping coordinate and control the activities of the Patient Accounting, Admissions, Switchboard, Physician Billing and Centralized Scheduling offices including but not limited to supervising and providing support to employee; ensuring that scheduling, insurance, financial and clinical data is accurately collected, analyzed and recorded on all patients, resulting in accurate billing and optimal collections. The Director ensures prompt, efficient, and courteous service to patients and their families. Responsible for training and monitoring the performance of staff and promoting a positive attitude within the department. The Director will review, maintain and recommend necessary changes to the Hospital Information System (Meditech) and the Electronic Billing System to insure that claims and accounts are processed promptly, efficiently, and accurately.

Critical Duties:

Develops and maintains a consistent standard of performance excellence within assigned areas. Serves as a consultant to department staff and management. Develops staffing requirement to ensure adequate staffing. Promotes positive interpersonal relationships with the executive and department management and medical staff to assure effective communication. Monitors and evaluates processes, outcomes, and services. Participates and implements performance improvement initiatives at the department level in a collaborative manner with multidisciplinary colleagues. Identifies appropriate internal controls for departments; provides mechanisms to monitor and enforce compliance. Monitors fiscal budget to control operational and capital expenditures while monitoring and adjusting staffing patterns to improve department productivity. Performs related duties as assigned.

Demonstrates Competency in the Following General Areas:

• Exemplifies and promotes among staff the JCMH Mission Statement and Standards of Performance.
• Focuses on quality service and goal attainment.
• Maintains awareness of organizational needs by making rounds.
• Works to improve job skills, knowledge and performance.
• Follows established personnel, department and facility policies.
• Attend mandatory educational programs identified by the facility.
• Maintains compliance with established billing standards, regulations, and laws.
• Maximizes the utilization and actively supports the continued development and use of the information systems within the department and organization.
• Supports and promotes among staff hospital preparation efforts to remain a JCAHO Accredited facility.
• Maintains the efficient operation of the departments.
• Commits to one hundred percent (100%) patient and customer satisfaction by always exhibiting a courteous and helpful manner during interactions with others, including patients, families, visitors, physicians and co-workers.
• Maintains a general, overall working knowledge of the department’s mission thereby having the ability to provide basic service and support to others, including patients, families, visitors, physicians and co-workers. Recognizes when others are in need of assistance and consistently offers to help when own workload permits.
• Fully knowledgeable of the comprehensive revenue cycle policies and procedural flow, and able to apply this knowledge to all situations.

Demonstrates Competency in the Following Primary Duties:

• Plans, organizes and directs Patient Financial Services activities and personnel. Continually reviews staffing, workflow and systems to identify optimal usage and effectiveness in order to ensure maximum hospital reimbursement and the highest quality of patient service. Creates or reviews policies and procedures regularly to ensure that documentation is accurate and available.
• Responds to patient questions, inquiries and complaints as needed and documents information on account to ensure that account history is maintained.
• Ensures that all scheduling, registration, admission and insurance information is obtained accurately and efficiently and that staff adheres to all hospital policies. Performs daily quality control checks and audits on scheduled appointments and provides staff with feedback on areas that need improvement.
• Maintains knowledge of HMO, PPO, Workers’ Compensation, Medicare, Medicaid and other insurance admission requirements to ensure Jackson County Memorial Hospital does not take unnecessary losses or cause the patient to pay unnecessary penalties; reviews online and paper-based insurance and legal resources to ensure that patients are admitted/registered accurately; interacts with external and internal resources using oral and written correspondence to resolve problems.
• Maintains overall working knowledge of the Meditech Admission and Scheduling modules to ensure that the admission/registration process is completed in the most efficient manner; oversees, coordinates and tests applications as necessary.
• Prepares Patient Financial Services reports on a daily, weekly, monthly or “as needed” basis to ensure that the Controller and hospital management are well informed.
• Coordinates and approves staff time and attendance to ensure that areas are adequately staffed at all times, unscheduled absences are documented appropriately and overtime is avoided.
• Encourages professional growth and development of department personnel through in-service education and other programs.
• Performs job specific duties and all other duties as assigned in a timely and accurate manner.
• Recruits, hires and retains a qualified staff.

Professional Requirements:

• Wears identification while on duty; meets dress code standards; appearance is neat and clean.
• Reports to work on time and as scheduled, uses time and attendance system correctly and completes work within designated time.
• Attends mandatory meetings; attends and/or reads minutes of other scheduled meetings.
• Respects patient confidentiality and uses discretion in discussion of patient information.
• Participates in continuing educational activities as deemed appropriate by department’s Manager or Director and completes annual education requirements in a timely manner.
• Follows hospital and departmental requirements for infection control and safety.

Educational/Experience/Regulatory Requirements:

• Ability to organize work, direct and set priorities, and effectively accomplish required duties with minimal or no supervision.
• A Bachelor’s Degree in Business Administration or equivalent is required.
• Two to four years’ previous acceptable experience in a Patient Financial Services, Patient Accounting, Accounts Receivable or Business office setting required. Experience in claims and remittance processing preferred.
• One to two years of supervisory experience or three years experience in a position that demonstrates leadership qualities required.
• Prior work history must demonstrate a thorough understanding of medical insurance, procedures related to filing claims, and understanding of medical records.
• Intermediate to Advanced level knowledge of Microsoft Excel, Microsoft Word and/or Microsoft Access preferred.
• Previous work history that demonstrates steady attendance and punctuality is required.

Language Skills:

• Must be able to read & communicate effectively in English.
• Must be able to communicate firmly what is required of patients in regards to their financial status.
• Must be able to communicate (orally and in writing) effectively with patients, doctors and other departments in the institution.

Physical Demands:

• Work may be stressful with regular patient contact. Must be able to meet, communicate, and work with patients and public directly, orally, and in writing.
• For physical demands of position, including vision, hearing, repetitive motion and environment, see attached description. Near visual & hearing acuity required to perform essential duties of position.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising client care.