The Executive Director of the Patient Financial Services is responsible for strategic leadership and direction for the overall operations of the back-end revenue cycle for the Health System which includes both hospital and professional revenue. Provides overall strategy and financial direction of Billing, Follow-up, Collections, Cash Posting, Refunds/Credit Balances, Denial Management, Customer Service, Bad Debt, Charity and Payor Variance activities in accordance with current applicable standards, guidelines, current laws and regulations..
The job duties listed are typical examples of work performed by positions in this job classification, and are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Specific duties and responsibilities may vary depending on department or program needs without changing the general nature and scope of the job or level of responsibility. Employees may also perform other duties as assigned.
1) Guides the development and implementation of short and long-range goals and objectives for the Health System's Patient Financial Services Units and revenue cycle programs. Provides leadership and expertise in the development, implementation, oversight, and evaluation of PFS strategies and initiatives for the system. Incorporates best practices and responds to emerging trends to enhance operations, programs, and/or services. Implements and evaluates strategic programs, develops effective tools to measure performance, analyzes related data, prepares reports, and makes recommendations to senior leadership based on findings.
2) Monitors and analyzes financial operations and key performance indicators, including but not limited to accounts receivable, cash collections, denials as a percent of net revenue, percentage of clean claims, controllable write-offs, candidate for billing, and discharged not final billed accounts, devising proactive strategies to ensure favorable outcomes.
3) Assumes a lead role in denial management initiatives, collaborating with various clinical and financial teams to evaluate and address root causes of payment delays and/or payer denials with focus on improving process workflows, optimizing revenue collections and reducing avoidable write-offs.
4) Communicates and implements new payer requirements that impact AR. Ensures changes are appropriately communicated and staff is trained.
5) Directs and participates in the development, implementation, and consistent application of effective organizational policies, procedures, and practices. Develops and supports internal controls to ensure that assets are safeguarded, policies and operating procedures are followed, necessary controls are effective and efficient, and compliance with current laws and regulations is achieved.
6) Builds and supports effective relationships with internal and external stakeholders and organizations. Develops partnerships, coordinates activities, reviews work, exchanges information, and/or resolves problems related to patient financial services/revenue cycle programs and continuous improvement initiatives.
7) Develops and oversees the department budget to meet corporate goals and objectives. Meets annual budgetary goals. Translates organizational plans, goals, and initiatives into assumptions for annual operating and/or capital budgets. Negotiates contracts with external vendors for products and/or services and monitors/evaluates quality and/or performance. Manages and reports expenditures and accounts payable transactions.
8) Serves as a subject-matter expert and may lead or facilitate task forces, teams, and/or councils to plan, implement and coordinate programs, services, and/or activities for the organization. May serve as a staff resource to the organization's Governing Board and/or applicable committees.
9) Performs trend analysis on third party payer payment levels to ensure that reimbursement is in accordance with allowable amounts stated in agreements and contracts. Works with appropriate individuals to resolve discrepancies.
10) Provides feedback and analysis to payers and Managed Care regarding payer issues, including AR Aging, Denials and Underpayments.
11) Directs processing of accounts receivable, adjustments/refunds, private and third-party agencies, ancillaries, cash deposits and posting.
12) Oversees all month end processes, including completion of data entry, review and correction of edits, and reconciliation of claims transactions.
13) Directs the preparation of accounts for outside collection agencies, attorneys, and write offs.
14) Maintains knowledge of third-party payer regulations including Medicare, Medicare Advantage, Medicaid, Champus, Workers Compensation and non-governmental payers.
15) Communicates the department vision, translating it into actionable projects and activities. Maximizes management staff's contributions and assures timely decision-making reflecting the mission, vision, and values of the system.
Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.
Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
Education: Bachelor's in Finance, Healthcare, Business or related field experience.
10 years of revelant revenue cycle management experience or finance experience at the Director level or above
Experience with strategic, client centered development and implementation, including operating policies and procedures, and work process improvements
Demonstrated ability to deliver financial results and solid process improvement
Knowledge, Skills and Abilities
These are the observable and measurable attributes and skills required to perform successfully the essential functions of the job and are generally demonstrated through qualifying experience, education, or licensure/certification.
Ability to interact with C level executives and present IT perspectives, roadmaps and strategies for increased efficiencies
Detailed knowledge and expertise across the entire hospital and professional revenue cycle continuum
Strong executive presence, including written and verbal communication skills that enable to appreciate of others perspectives and the ability to offer compelling insights and recommendations to key internal and external stakeholders, senior leadership, peers and board members
Outstanding management abilities and a demonstrated track record of leadership
Expertise with responsibility for large groups of employees is required
Strong analytical capacity
Capability to serve as both a leader and a coach with demonstrated ability to work as a team or independently
Thorough understanding of healthcare financial trends and financial systems/tools
A proven leader with significant revenue cycle experience to lead the integration of all back-end revenue cycle process
Demonstrates a desire to provide guidance in order to help direct reports achieve growth, established goals, and desired outcomes
True "change agent" able to lead diverse groups in implementing new programs and ideas
Skilled in leading change management to implement new and "best practice" approaches to business processes to improve customer service, operational effectiveness and financial outcomes
A courageous, innovative and energetic individual with a "can do attitude" that can inspire an organization to do its best and stay the course even in difficult circumstances
Exhibits strength of character to champion risk taking; a self-starter and self-motivated
A true collaborator, that can influence by actively listening and bringing multi-disciplinary teams (clinical operations, care providers, administration, etc.) together
Prepares organizational leadership to recognize and mitigate risks brought on by organizational changes
Serve as the transformation advocate to generate enthusiasm and excitement for the change
Strong understanding of information technology and its applications in revenue cycle management
Ability to successfully function in a fast paced, service oriented environment