Director of Patient Financial Services

JOB TITLE: Director of Patient Financial Services

JOB SUMMARY:
The Director of Patient Financial Services (PFS) is responsible for the strategic leadership, direction, and overall performance of the revenue cycle and patient financial operations. Reporting to the Chief Financial Officer (CFO), this role oversees all aspects of billing, collections, reimbursement, patient access financial workflows, and medical records functions to ensure optimal financial outcomes and regulatory compliance.

The Director provides leadership to key functional areas including Billing, Revenue Cycle, Medical Records, Prior Authorization, and Financial Counseling through direct oversight of the PFS Supervisor, Revenue Cycle Lead, Medical Records Lead, and Prior Authorization Lead, as well as indirect oversight of Financial Counselors. This position is accountable for developing and executing strategies that enhance revenue integrity, improve cash flow, reduce denials, and elevate the patient financial experience.

This role partners closely with clinical and operational leadership to identify barriers to care, implement financial solutions, and ensure alignment between financial processes and patient care delivery. The Director ensures compliance with all federal, state, and payer regulations and drives continuous process improvement across the revenue cycle.

REPORTS TO: Chief Financial Officer (CFO)

PRINCIPAL DUTIES: (This list may not include all duties assigned.)

• Provides strategic oversight and leadership of all Patient Financial Services functions, including billing, coding support, charge capture, claims processing, payment posting, denial management, prior authorization, medical records, and financial counseling.
• Leads and develops a high-performing team through direct supervision of departmental leaders and indirect oversight of support staff; establishes clear expectations, accountability, and performance metrics.
• Develops, implements, and monitors revenue cycle strategies to optimize reimbursement, reduce accounts receivable days, and improve clean claim rates and denial resolution.
• Oversees payer relationships and reimbursement methodologies; analyzes remittance data to identify trends, variances, and opportunities for financial improvement.
• Ensures effective denial management processes, including root cause analysis, corrective action planning, and ongoing performance monitoring.
• Collaborates with clinical and operational leadership to identify and address barriers to patient care related to financial constraints; develops and implements solutions to support patient access and continuity of care.
• Oversees prior authorization and insurance verification processes to ensure timely approvals and minimize delays in treatment.
• Ensures accurate charge capture and coding practices; partners with providers and staff to provide education and maintain compliance with current coding and billing regulations.
• Maintains oversight of fee schedules, payer contracts, and reimbursement structures, including specialty drug and infusion billing.
• Directs the development and maintenance of policies, procedures, and internal controls to ensure compliance with regulatory requirements, including Medicare, Medicaid, and commercial payer guidelines.
• Monitors key performance indicators (KPIs) and prepares regular reports for executive leadership; uses data analytics to drive decision-making and process improvements.
• Leads system optimization efforts, including billing software, claims editing tools, and revenue cycle technologies; troubleshoots escalated system or process issues.
• Leads workflow redesign and system optimization initiatives to improve operational efficiency, reduce manual workarounds, standardize revenue cycle workflows, and improve staff adoption of best practices within revenue cycle systems.
• Oversees medical records functions to ensure accurate, timely, and compliant documentation and release of information.
• Ensures patients receive accurate financial counseling and support, including referrals to financial assistance programs, medication assistance programs, and external resources.
• Fosters effective communication and collaboration across departments to support organizational goals and patient-centered care.
• Participates in leadership meetings, committees, and strategic planning initiatives as requested.

PERFORMANCE REQUIREMENTS:
Strong leadership, strategic thinking, and decision-making skills are essential. The Director must demonstrate the ability to lead through change, drive operational excellence, and influence cross-functional teams. Requires advanced knowledge of revenue cycle operations, healthcare reimbursement methodologies, and regulatory requirements.

• Excellent communication and interpersonal skills with the ability to engage effectively with executives, providers, staff, patients, and external stakeholders
• Demonstrated ability to analyze complex data, identify trends, and implement effective solutions
• Strong understanding of Medicare, Medicaid, and commercial payer regulations and their operational impact
• Proven ability to develop and maintain high-performing teams and a culture of accountability
• Ability to manage multiple priorities and adapt to a dynamic healthcare environment
• Expertise in compliance, audit processes, and quality assurance within revenue cycle functions

TYPICAL PHYSICAL DEMANDS:
Requires full range of motion including manual and finger dexterity and eye-hand coordination. Occasionally lifts and carries items weighing up to 50 pounds. Requires corrected vision and hearing within normal range.

EDUCATION:
Bachelor’s degree in Healthcare Administration, Business Administration, Finance, or a related field required. Master’s degree preferred.

EXPERIENCE:

• Minimum of 7–10 years of progressive experience in revenue cycle management, patient financial services, or healthcare finance
• Minimum of 3–5 years in a leadership role with direct supervisory responsibility
• Extensive experience with physician billing, accounts receivable management, claims processing, denial management, and insurance recovery processes
• Strong working knowledge of automated billing systems and revenue cycle technologies
• Experience with Medicare, Medicaid, and commercial payer environments
• Oncology experience strongly preferred

ALTERNATIVE TO MINIMUM QUALIFICATIONS:
Equivalent combination of education and extensive relevant experience may be considered in lieu of degree requirements.