Job Description

Description

The Manager of Patient Financial Services (PFS) is directly responsible for the daily oversight of operational processes and workflows specific to district’s revenue cycle; including admissions, hospital and professional billing, cash posting, and/or customer service across the Eastern Plumas Health Care District . The manager is responsible for managing PFS staff to achieve expected productivity and quality goals.

This position is responsible for aligning processes and performance with the broader revenue cycle goals and Eastern Plumas Health Care’s objectives and assists in the development and evolution of the overall strategy for Eastern Plumas Health Care’s revenue cycle operations. The manager assists the Chief Financial Officer with planning, service commitment, budgets and internal quality assessments and controls.

The manager serves as a key promoter of PFS operations and actively participates in building positive working relationships with other Revenue Cycle departments, clinical providers and practice staff. The manager acts as a resource for all of Eastern Plumas Health Care’s issues related to district’s revenue cycle.

This is a Full Time Benefited Position.  At EPHC we offer a comprehensive benefits package including: Health, Dental, Vision, Retirement, 8 paid holidays, and much more!

Principal Accountabilities:

  • Supports the Mission, Vision and Values of Eastern Plumas Health Care.
  • Embraces and supports the Performance Improvement philosophy of Eastern Plumas Health Care.
  • Promotes personal and patient safety.
  • Promotes employee satisfaction.
  • Uses effective customer service/interpersonal skills at all times.
  • Adheres to established National Uniform Billing Committee and other payer specific guidelines when developing and implementing billing policy and procedures.
  • Develops and implements goals, objectives and productivity targets incorporating strategic imperatives. Reviews, reports on progress, and revises as necessary.
  • Keeps current on reimbursement and billing issues. Implements the changes in the district’s current practices. Acquires and maintains thorough knowledge of Federal and State legislative and administrative action affecting reimbursement; disseminates acquired knowledge to Revenue Cycle team.
  • Establishes and monitors auditing and billing office policies to ensure maximum reimbursement. Recommends, and implements policies and procedures as needed to maximize reimbursement for all services rendered in compliance with established third-party guidelines.
  • Establishes and implements controls to ensure accurate, timely, and appropriate submission, billing, and payment cycles.
  • Hires employees, manages human resource utilization and supports staff development.
  • Approves bi-weekly payroll records and maintains electronic attendance records on personnel.
  • Maintains personal knowledge of Eastern Plumas Health Care personnel policies and administers these fairly and uniformly. Ensures evaluation of performance of all staff on going on a timely basis and recommends appropriate action. Utilizes progressive corrective action according to policy.
  • Develops and maintains up-to-date and standardized departmental policies and procedures and provides accurate interpretation to correct problems and enhance optimal efficiency.
  • Interprets the priority of work activities and assigns responsibility accordingly. Independent judgment is exercised.
  • Acts as a resource and active leader in solving moderate to complex problems related to District’s billing processes.
  • Works closely with outside collection agencies.
  • Identifies and tracks key barriers and process defects and takes action for sustained resolutions, utilizing appropriate process improvement techniques.
  • Coordinates with the internal quality team to review, determine the root cause(s), and remediate quality issues; ensures implementation of performance improvement plans to ensure compliance with all applicable standards.
  • Conducts ongoing PFS team meetings and huddles.
  • Attends and/or presents at meetings as necessary or upon request.
  • Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of the latest trends.
  • Performs all other duties as assigned.

POSITION REQUIREMENTS: To competently perform the duties of this position a Bachelor’s Degree in Health Information Management, Health Care Systems Administration, Finance, or Business related field is required. Consideration may be given to candidates with an Associate’s Degree in a Healthcare, Finance, or Business related field with 5 or more years extensive, applicable experience. The ideal candidate possesses a comprehensive understanding of Medicare and Medi-Cal reimbursement practices.

  • Current standing as a Certified Healthcare Finance Professional (CHFP) or Certified Revenue Cycle Representative (CRCR) preferred.
  • A minimum of 5 years supervisory or leadership experience is required.
  • A comprehensive knowledge and understanding of the revenue cycle, with particular emphasis on Critical Access Hospital (CAH) and Rural Health Clinic (RHC) billing is preferred. A working knowledge of revenue cycle practices for professional services is highly desirable.
  • Demonstrated knowledge of National Uniform Billing Committee (NUBC) requirements.
  • Demonstrated strong problem-solving skills with ability to manage cross-functional resolutions against a deadline are required.
  • Demonstrated ability in effective communication, motivational and interpersonal relationship skills is required. Proven ability in written and oral communication is required. Demonstrated comprehensive quality customer service experience preferred.
  • Previous experience in creating, providing or facilitating meeting and/or training presentations is required.
  • Must be able to demonstrate good judgment, be self-motivated and well organized.
  • Demonstrated ability to prioritize key tasks and work in a complex, stressful environment is required. Must be able to simultaneously manage multiple projects and staff.

WORKING RELATIONSHIPS: The manager reports directly to the Chief Financial Officer. The manager maintains close working relationships with the Chief Executive Officer, Chief Financial Officer, administrative staff, and other supervisory and management personnel of the district. The manager directly supervises the daily operations of the Admissions, Billing, Cash Posting, Credit, Collections, and Patient Financial Services employees. Frequent contact with third party payers and vendors to ensure smooth cash flows. Other routine contact includes key individuals with collections agencies, governmental agencies, health finance associates and peers from other facilities.

FREEDOM TO ACT/ACCOUNTABILITY: The Patient Financial Services Manager has the authority to hire, fire, discipline, appraise performance and approve merit increases of employees. Within hospital policy approves departmental expenditures, refunds, bad debt write-offs, collection agency assignments and administrative adjustments. Has full authority and responsibility for daily departmental operations.

PRIVACY AND CONFIDENTIALITY: As set forth in the Health Insurance Portability and Accountability Act of 1996 (HIPAA), this position must maintain patient confidentiality in accordance with State and Federal regulations.

Protected Health Information is restricted to a need-to-know basis. Any intentional or unintentional breach of confidentiality will be reported to the HIPAA Privacy Officer and is subject to disciplinary action, up to and including termination of employment.