The Patient Financial Servcies (PFS) Manager is responsible for managing the overall functions of the Kearney Regional Medical Center (KRMC) Patient Financial Services area. To ensure maximization of revenue and cash flow while maintaining the highest levels of patient, physician, employee and other customer relations. Areas of responsibility include insurance billing, insurance follow-up and maintenance, billing compliance, auditing departmental charging processes and results, denials management both inventory management and denial avoidance, integrity of patient accounts & actively responsible for accounts receivable management. In collobration with System Revenue Cycle departments assist in charge master maintenance, charging compliance, cash posting, patient collections, patient complaints and financial counseling.
- Commits to the mission, vision, beliefs and consistently demonstrates our core values.
- Provides overall vision and direction as well as developing goals for the PFS team at KRMC.
- Collobrates with the entities Revenue Cycle Director in a matrixed leadership model with the entities leadership.
- Oversees the operations of insurance billing, insurance follow-up and maintenance, billing compliance, auditing departmental charging processes and results, denials management both inventory management and denial avoidance, integrity of patient accounts & actively involved with accounts receivable management.
- Responsible for Denials Management both Inventory Management and Denial Avoidance strategies.
- Manages the work processes within the all the areas listed above; adjusts work assignments to maintain optimal accounts receivable and customer relations; develops work standards, monitors quality and quantity of work processed and ensures that policies are communicated and administered consistently.
- In connection with the Bryan Health System Revenue Cycle departments, recommendas updates for Charge Master items: evaluates fee schedules annually and adjusts Charge Master accordingly, assures charging compliance, assists where applicable with cash posting, patient collections, patient complaints and financial counseling.
- Serves as the PFS expert and go to person for all PFS processes.
- Evaluates the status of patient accounts to identify and resolve billing processing problems in a timely manner.
- Works closely with hospital leadership and Bryan Health Revenue Cycle System Leadership to monitor compliance to policies and procedures as they relate to the PFS.
- Prepares and analyzes accounts receivable reports, weekly and monthly financial reports. Collects and compiles accurate statistical reports. Distributes month-end reports to the Revenue Cycle Director and to KRMC Leadership when applicable.
- Solves difficult payment and associated business office problems; audits problem accounts.
- Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and are compliant to all Federal, State, and payer regulations, guidelines, and requirements.
- Reviews and interprets operational data to assess need for procedural revisions and enhancements; participates in the design and implementation of specific systems to enhance revenue and operating efficiency.
- Analyzes trends impacting charges, billing, collection, and accounts receivable management and take appropriate action to realign staff and revise procedures if necessary.
- Supervises PFS personnel, which includes work allocation, training, and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peak productivity and performance.
- Actively participates in administrative meetings and committees as appropriate.
- Performs other related duties as assigned.
Education/Experience:Bachelor's degree in health administration, business administration, finance or related field required. Master's degree in business administration (MBA), health administration, or professional designation such as CMA is preferred.
A minimum of eight (8) years of progressively responsible leadership experience in revenue cycle (ex. lead role, supervisor, positions with increased responsibilities) within a health care environment is required; experience in a multi-facility leadership structure and EPIC is preferred.