Senior Manager Of Patient Financial Services

The Senior Manager of Patient Financial Services oversees all functions related to the organization’s revenue cycle, from patient registration through final account resolution. This leader ensures accurate charge capture, efficient billing, timely collections, denial management, and compliance with all payer regulations. The Senior Manager provides strategic direction, operational oversight, and continuous improvement to maximize reimbursement, reduce bad debt, and optimize financial performance. 

OVERSIGHT

Service Line(s)

• Patient Financial Services, Hospital Patient Access, Authorizations, Billing

Positions(s)

• Manager of Admitting
• Chargemaster Revenue Integrity Specialist
• Revenue Integrity Specialist II
• Authorizations Lead
• Authorizations Specialist
• Authorization and Eligibility Coordinator

STANDARD EXPECTATIONS

• Creates a Positive Working Environment
• Builds and maintains a positive atmosphere in line with organization mission, vision, values and standards of behavior.
• Models organizational values and standards of behavior.
• Accepts new responsibilities and challenges with a positive attitude.
• Facilitates the resolution of difficult interpersonal situations.
• Holds staff accountable to organizational policy.
• Partners with other leaders to improve inter-department processes.
• Supports and maintains a culture of safety and quality.
• Leads and/or participates in committees as assigned.
• Communicates Effectively
• Builds relationships and works collaboratively with other leaders and staff.
• Provides timely operational updates to supervisor.
• Conducts routine meetings with staff and encourages an exchange of information.
• Responds to communications in a timely manner.
• Operates Efficiently and Effectively
• Develops and monitors department budgets.
• Manages staff including hiring, scheduling, performance evaluation and following the disciplinary process.
• Develops procedures and competencies for direct reports and ensures they are properly trained and educated.
• Develops department policy.
• Measures and monitors staff productivity.
• Identifies and initiates department process improvements. 
• Procures or requests necessary resources to efficiently provide services.
• Mentors and guides potential leaders.
• Ensures compliance with applicable federal, state, and local regulations.
• Performs other duties as assigned.
• Applies Critical and Strategic Principles
• Assists in developing strategic objectives to help achieve the organization’s vision.
• Assists in developing and implementing major cost reduction efforts when needed.
• Critically analyzes perspectives, alternatives, and potential impact when solving complex strategic and operational issues.
• Assists in negotiating contracts to assure provision of services.

DUTIES & RESPONSIBILITIES

Revenue Optimization

• Manage organization wide charge audit function and monitoring compliance with WHMC policies and procedures
• Monitor regulatory changes, including Medicare and Medicaid, and assures that unit staff are in compliance.
• Develop and implement policies and procedures that will improve internal control.
• Oversee payer contract compliance and related reimbursement auditing and oversight

Billing

• Oversee billing functions of the organization
• Monitor denials and communication of denials to source department.
• Development and monitoring of denial prevention plan
• Monitor productivity of billing teams / company and maintain an environment of accountability
• Develop key performance indicators to monitor billing and financial health of revenue cycle

Authorizations

• Manage centralized authorizations function for all organizational authorization functions except those originating as Primary Care Clinic referrals.
• Oversee organizational tracking of services requiring pre-authorization
• Ensure services offered at WHMC are provided to patients with the appropriate pre-authorization requirements per payor policies.

Patient Access

• Provide strategic and operational leadership for Hospital Patient Access functions, including scheduling, registration, insurance verification, financial counseling, and pre-authorization.
• Oversee daily operations to ensure timely, accurate, and compliant patient registration and financial clearance processes.
• Manage and develop front-end supervisors, team leads, and staff to ensure high-quality service and compliance with organizational standards.
• Establish and monitor key performance indicators (KPIs) for organization wide Patient Access such as registration accuracy, insurance verification timeliness, authorization turnaround time, and point-of-service collections.

Operational Efficiency & Process Improvement

• Develop and implement standard operating procedures (SOPs) to optimize patient access workflows and reduce wait times.
• Lead initiatives to integrate technology (EHR, patient portals, eligibility tools, real-time authorization systems) to streamline registration and financial clearance.
• Monitor productivity metrics and staffing levels to ensure adequate coverage and efficient use of resources.
• Drive continuous improvement projects to enhance patient experience, staff engagement, and revenue cycle performance.

Financial Clearance & Revenue Integrity

• Ensure insurance eligibility, benefits verification, and pre-certification processes are completed prior to service to prevent claim denials and payment delays.
• Oversee estimation of patient liabilities and ensure patients are informed of their financial responsibilities before or at the time of service.
• Collaborate with billing and reimbursement teams to reduce front-end errors that cause claim rejections or payment delays.
• Partner with Revenue Integrity to identify root causes of registration and authorization denials and implement corrective actions.

Revenue Cycle Leadership

• Provide billing, charge, and denial data and support to leaders in varying organizational departments
• Monitor and report revenue cycle KPI’s to supervised teams as well as executive management.

Compliance

• Monitor and ensure compliance with federal pricing transparency regulations
• Ensure compliance with billing related rules and regulations
• Identify new regulations with organizational impact and develop and implement associated compliance plans.

QUALIFICATIONS

Required

• Associate’s degree in business administration or minimum of two years in current Bachelor’s degree program.
• Minimum of ten (10) years of experience in hospital revenue cycle position.
• Minimum of three (3) years of supervisory experience in revenue cycle management.
• Strong knowledge of ICD-10, CPT, HCPCS, and reimbursement methodologies.
• Familiarity with CDM maintenance, claim edits, and payer rules.
• Knowledge of Critical Access Hospital Medicare and Medicaid billing and reimbursement concepts and principles

Preferred

• Bachelor's degree in healthcare administration, business administration or related field.
• Proficiency with EPIC EHR and revenue cycle system
• Certification such as CPC, CCS, RHIA, RHIT, or CHRI