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Director-Patient Financial Services

Company: Stanford Health Care
Location: Palo Alto
Posted on: June 6, 2021

Job Description:

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.A Brief OverviewThis position directs the Patient Financial Services (PFS) department which has the responsibility for all patient related business activities including patient billing, insurance billing, governmental program billing, commercial/managed care billing, special billing (transplants, grants, IMS, sports medicine), payment application, customer service, collections and patient advocacy. Assures compliance of regulatory requirements, facilitates communication and provides effective leadership. Will have responsibility for ensuring the provision of best practice, customer-focused and cost-effective patient financial services for the organization.What you will doMonitors and evaluates current reimbursement/payment rules and ensures that legislative and regulatory changes impacting PFS billing practices and operations are anticipated and communicated to senior management, clinical department chairs, staff, and departmental billing personnel. Develops plans and initiate response to legislative changes.Oversees resolution of third party denials and assists with reimbursement appeals and problems.Directs operation of revenue collection; develops policies and procedures that ensure appropriate effectiveness of collection of accounts receivable.Monitors and maintains all outsource vendor and collection agency relationships to ensure they are in compliance with system policy, and state and federal regulations including quality and maximum return on investment. Provide targets and goals to measure effectiveness and report on the attainment of the goals.Directs operation of third party billing and responsible for development of policies and procedures that ensure the appropriate maintenance of PFS commercial, governmental, managed care, and special billing and accounts receivable systems.Develops departmental strategies to meet cash projection formulas, reduce days in Accounts Receivable, and reduce denials.Directs operations of cash posting and oversees the coordination and activities of cash posting with those of other departments within PFS and the Hospital. Oversees the activities related to the maintenance of the EPIC Account Receivables System and responsible for reconciliation of EPIC system to General Ledger (GL).Ensures that accounts receivables system report and Critical Reduction Schedule (CRS) tools are used as daily management tools for successful ongoing and proactive management of A/R. Challenges Managers to question trends, unusual numbers, and source documents to ensure they understand what the numbers represent, and what actions are required to resolve issues identified.Manages the department to ensure achievement of functional and budget/financial goals. Selects, develops, motivates and evaluates the performance of assigned supervisors and/or individual contributors.Oversees Accounts Receivables system administration reporting and distribution. Monitors delinquent aging percentages, bad debt write-offs and ensures progress toward goals; evaluates revenue trends and the impact on the accounts receivable (A/R) days calculation.Oversees coordination of defense audit with insurance companies; reviews over charges and undercharges on a monthly basis and directs upstream process changes; oversees the reporting of charity and governmental patient health care subsidy funding.Represent Patient Financial Services' contributions, issues, and solutions to organization-wide groups and committees such as A/R Task Force, In-house High Dollar Account Review, etc. to ensure appropriate communication and problem solving across the Revenue Cycle.Reviews and evaluates on a regular basis, the effectiveness of third-party billing, tracing and follow-up activities; oversees development and maintenance of good working relationship with third parties and government agencies receiving claims from PFS.Maintains knowledge for all insurance, government, HIPAA, compliance, health care reimbursement, OIG projects, and general billing practices and state regulations/laws to ensure Patient Financial Services is following the appropriate guidelines/regulation and remains in compliance with the same. Act as the Patient Financial Services liaison with State and Federal fiscal intermediaries as needed or requested.Education QualificationsBachelor's degree in a work-related field/discipline from an accredited college or university, or equivalent combination of education/experienceExperience QualificationsTen (10) years of progressively responsible and directly related to the management of hospital Patient Financial Services is requiredRequired Knowledge, Skills and AbilitiesAbility to analyze complex changes in third party payor requirements for impact on operations and make related recommendationsAbility to develop long-range business plans and strategyAbility to foster effective working relationships and build consensusAbility to identify and correct data collection, billing, and/or collection procedural or systems deficienciesAbility to mediate and resolve complex problems and issuesAbility to provide leadership and influence othersAbility to stay abreast of all Governmental and industry trends in the functional areaDemonstrated interpersonal skills; success at cultivating strong relationships with internal and external stakeholders and creating partnerships at all levels within the organizationManages up and self extremely wellDemonstrated and effective written and oral communication skillsAbility to effectively manage complex issues simultaneouslyAbility to effectively present complex issues to internal and external customersStrong familiarity with information and accounting systemsAbility to assess and evaluate complex financial dataDemonstrated workflow and analytical thinking skillsDemonstrated communication skills and ability to effectively communicate with all levels, including senior executive levelsKnowledge of accounting/finance principles that directly impact the account receivables, charge transfers, contractual allowances and adjustments, financial class changes and revenue reclassification, and reserve methodology and mechanicsKnowledge of third-party billing and collection processes, with particular focus on billing requirements, contractual arrangements, utilization guidelines, and certification/authorization processes, for both institutional and professional feesDemonstrated analytical ability and organizational skills necessary to assess, prioritize, and organize information/tasks, and provide timely recommendations based on analytical assessmentHighly confident, results-driven person; focused on achieving the goals of the organizationKnowledge of CPT, ICD-9 codingKnowledge of automated billing systemsKnowledge of local, state and federal regulatory requirement related to the functional areaKnowledge of principles and practices of organization, administration, fiscal and personnel managementKnowledge of private insurance and other third party billing, follow-up and collection requirementsThese principles apply to ALL employees:SHC Commitment to Providing an Exceptional Patient & Family ExperienceStanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanfords patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.You will do this by executing against our three experience pillars, from the patient and familys perspective:Know Me: Anticipate my needs and status to deliver effective careShow Me the Way: Guide and prompt my actions to arrive at better outcomes and better healthCoordinate for Me: Own the complexity of my care through coordination#LI-RL1Equal 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.At Stanford Health Care, we seek to provide patients with the very best in diagnosis and treatment, with outstanding quality, compassion and coordination. With an unmatched track record of scientific discovery, technological innovation and translational medicine, Stanford Medicine physicians are pioneering leading edge therapies today that will change the way health care is delivered tomorrow.As part of our spirit of discovery, we also leverage our deep relationships with luminary Silicon Valley companies to develop new ways to deliver preeminent patient care.Learn about our awards (and significant events (.

Keywords: Stanford Health Care, Palo Alto , Director-Patient Financial Services, Other , Palo Alto, California

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