Director, Patient Financial Services, Hospital Billing

t NorthBay Health, the Director of Patient Financial Services Hospital Billing (HB) will be responsible building and leading a highly effective centralized billing, follow-up, and collections department for NorthBay Health hospitals, ambulatory surgery centers, collaborate closely with and contributed to the success of other areas of the NorthBay Revenue Cycle, including but not limited to, front-end and middle revenue cycle operations, ambulatory revenue cycle operations, as well as collaborating with non-Revenue Cycle areas of NorthBay to contribute to the overall operational, financial, quality, and safety achievements and excellence of NorthBay Health. This includes mentoring, guiding, developing, training, and evaluating the patient accounting team.

PRIMARY JOB DUTIES/RESPONSIBILITIES

1. Manages hospital, facility, and technical services billing and revenue collection, follow-up, and accounts receivable of all NorthBay hospital, facility, and technical billing, including non-profee post-acute services.

2. Collaborates with the larger Revenue Cycle Team and the NorthBay operational, IT teams, providers, administrative teams, and leaders to provide an excellent patient experience and patient care.

3. Plans, organizes and manages all activities of the Patient Financial Services Department.

4. Recommends and implements policies and procedures as appropriate to enhance the billing and collection process.

5. Recommends and implements policies and procedures to enhance the collection of information necessary to manage capitation, contracting and reimbursement of services provided.

6. Reviews billing, coding, provider billing manuals and regulatory requirements with staff and physicians to ensure required ongoing education is provided and to maintain billing compliance with all contractual and regulatory stipulations.

7. Reviews and communicates all managed care and other third-payor contracts to ensure smooth and efficient processing of claims and reimbursements.

8. Prepares accurate and timely financial reports in order to measure the effectiveness of billing, compliance and productivity.

9. Develops audit mechanisms in order to provide enhanced education on coding, reimbursement and billing compliance.

10. Provides accurate and timely operational and program reviews accompanied by reports that reflect analysis and summary conclusions and, as appropriate, outlines recommendations and alternatives.

11. Establishes and evaluates work system designs, policies and procedures, standards and protocols to enhance departmental productivity.

12. Administers the administrative and personnel policies of the System in a consistent and uniform manner.

13. Responsible for achieving system Key Performance Indicators (KPI), Benchmarks, and system goals as established by Revenue Cycle and NorthBay Leadership.

14. Work with other departments and make sure all the billing defects and denials are getting fixed at the area of origin.

1. Education: Bachelor’s degree in Finance, Business Administration, Health Administration, or a related field, other majors will be considered if balanced with at least 10 years directly related revenue cycle experience.
2. Licensure:   None 
3. Experience:   Minimum of 8 years in a healthcare setting with directly related Revenue Cycle experience, including at least 3 years in a leadership role within a healthcare setting. Knowledge of business acumen and EMR experience required. Comprehensive knowledge of Revenue Cycle operations and reimbursement principles, and of federal and state compliance regulations, HIPAA, Title 22, The Joint Commission regulations and CMS Audit guidelines.  Comprehensive knowledge of EHR applications pertinent to health information management and computerized data repository functions required. Specific experience with either Cerner Millennium or EPIC Systems is preferred. Proven track record of driving revenue cycle performance improvements and managing cross-functional teams.
4. Skills:   Excellent oral and written communication skills required.  Must possess teaching ability, leadership ability, and high professional standards.  Must be well organized, be able to set priorities, work independently and is an effective team member.  Word Processing skills required.  Demonstrated abili