What are the responsibilities and job description for the Enterprise Director, Patient Financial Services, Professional Billing position at West Virginia University Hospital?
Directs service delivery for all
business office processes, practices, and system support across all UHA,
WVUHS, and outreach physician services in locations throughout West Virginia
and the surrounding communities. Responsible for the management of
accounts receivable for professional billing, impacting a major source of
revenue. Develops and controls all tasks necessary to ensure all business
office activities are completed on-time, including building relationships
with internal and external clients throughout the WVU Medicine enterprise.
Utilizes internal resources and analytical skills to make decisions in
fast-paced, fluid environment. Accountable for making strategic decisions
guided by organizational challenges, trends, and business implications,
keeping in mind that decision may have regional/local
implications. Recognizes cross-function interdependencies
of decision. May challenge decisions where precedents have been set and
communicates rationale with stakeholders to gain consensus. Supports
the success of a high-performing business office by helping to champion and
drive long term success, achieving results comparable to national best
practices. Achieves highest standard of customer service while
maximizing resolution of balances due. This position will be based out of
Morgantown, WV.
MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1.
Bachelors
Degree
EXPERIENCE:
1.
5
years management experience required
2.
Five
(5) years of experience in healthcare finance
PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1.
Bachelors
Degree in Accounting, Finance, or Business
2.
Masters
Degree, Certified Healthcare Financial Professional (CHFP) of HFMA
EXPERIENCE:
1.
Experience
developing standards, processes, policies and procedures for a diverse organization
2.
Record
of success managing complex projects with multiple, diverse stakeholders.
3.
Prior
experience with Epics Hospital Billing module
4.
Experience
working in an organization of size and complexity comparable to WVU Medicine.
CORE
DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the
general nature of work being performed by people assigned to this position.
They are not intended to be constructed as an all-inclusive list of all
responsibilities and duties. Other duties may be assigned.
1.
Senior
position over billing processes for WVU Medicines professional billing
function. Assures the accurate and timely billing and collection of
professional revenue by managing billing, collections, and other support
areas to these integrated functions for all professional providers practicing
at sites throughout West Virginia and surrounding
communities.
2.
Directly
supervises a team of Patient Financial Services
Managers.
3.
Provides
strategic leadership to patient financial services department through
innovative ideas, reasoned risk taking, and thoughtful and thorough
implementation strategies.
4.
Reduce
denials through analysis of payer behavior and billing processes to best
practice levels.
5.
Interprets
and communicates healthcare payment policies and practices and devises
strategies to maximize reimbursement to maintain cash flow at established
levels.
6.
Analyzes
financial policies and procedures as they relate to patient financial
services and implements changes to achieve best practice levels for revenue
cycle metrics.
7.
Assures
cost reimbursement criteria followed and maintained to ensure correct
reporting and cost reimbursement. Ensures close cooperation, planning and
strategic alliances with all areas affecting reimbursement outcomes.
8.
Continually
monitors and optimizes service functions based on changing environment and
customer requirements.
9.
Maintains
system level patient collection policies that are compliant with State and
Federal regulations.
10.
Analyzes
and manages accounts receivable variables that are very complex due to
constantly changing rules and regulations imposed by managed care companies,
third party payers, and governmental agencies. Develops payer
relationships to assist in resolution of complex payment and billing issues
as they arise.
11.
Writes,
interprets, adapts and enforces organizational and departmental policies as
needed with management, employees and third party payers and customers.
12.
Ensures
financial reporting for state, federal and hospital record keeping and
reporting regulations are met.
13.
Provides
support and advice on the design and practically of HMO, PPO, etc. billing
arrangements, collection procedures, and compliance of managed care
contracts.
14.
Functions
as primary resource for all professional Patient Financial Services decisions
for information technology, patient access, medical records, utilization
management, ancillary revenue departments, etc. for the WVU Medicine
enterprise.
15.
Plans
and sets goals with all related areas to ensure decisions are optimal for
organizational goals and consistent with missions, administrative philosophy
and guidelines.
16.
Ensures
physician relationships are developed and maintained to reflect collaborative
environments.
17.
Sets
goals and standards with leadership team to ensure standardization, quality,
and timeliness of patient financial services operations throughout the
system.
18.
Ensures
that local and regional issues are resolved in a timely manner and
consistently with the operations of other regions within the system.
19.
Acts
as a primary conduit for the EPIC PB module, ensuring that all system
implications of change requests are reviewed keeping local and regional
impacts in mind at all times.
20.
Serves
as representative of department and team within the organization. Integrates
department operations into clinical operations where needed.
21.
Manages
cash posting, refunds and cash reconciliation for all sites to ensure
efficient and accurate posting of cash and reconciliation of cash to bank
deposits.
22.
Ensures
employee evaluations are objective, address employee performance and
timely.
23.
Prepares
and administers annual operating and capital budgets for department,
reporting variances where required.
24.
Responsible
for managing billing and customer service functions for any contract billing
functions within the department.
PHYSICAL
REQUIREMENTS: The physical demands described here are representative of those
that must be met by an employee to successfully perform the essential
functions of this job. Reasonable accommodations may be made to enable
individuals with disabilities to perform the essential functions.
WORKING ENVIRONMENT: The work environment
characteristics described here are representative of those an employee
encounters while performing the essential functions of this job. Reasonable
accommodations may be made to enable individuals with disabilities to perform
the essential functions.
1.
Office
work which includes sitting for extended periods of time
2.
Travel
to all business office sites required
SKILLS
AND ABILITIES:
1.
Must have
strong oral, written and analytical abilities.
2.
Must be able
to supervise personnel to effectively represent the department and hospital
in interactions with payers, patients, physicians and other departments.
3.
Must also
have ability to perform a variety of duties, ranging from direct involvement
in various procedures to coordination of activities of many subordinates.
4.
Experience
with Microsoft Office required.
5.
Experience
with EPIC or similar system preferred.
6.
Experience
managing complex/ large scale/ transformational projects, including
demonstrated success in coordinating major projects.
7.
Experience
developing standards, processes, policies, procedures and service level
agreements.
8.
Demonstrates
leadership in planning new or expanded services, managing projects and
coordinating multi-department task forces.
9.
Demonstrates
mastery in Patient Financial Services
10.
Understanding
and experience with performance metrics.
11.
Ability to
establish, develop and manage collaborative professional relationships.
12.
Experience
developing and managing department budgets.
13.
Aptitude to conceptualize,
plan, and implement stated goals and objectives.
Date
Reviewed/Revised: January 2022
business office processes, practices, and system support across all UHA,
WVUHS, and outreach physician services in locations throughout West Virginia
and the surrounding communities. Responsible for the management of
accounts receivable for professional billing, impacting a major source of
revenue. Develops and controls all tasks necessary to ensure all business
office activities are completed on-time, including building relationships
with internal and external clients throughout the WVU Medicine enterprise.
Utilizes internal resources and analytical skills to make decisions in
fast-paced, fluid environment. Accountable for making strategic decisions
guided by organizational challenges, trends, and business implications,
keeping in mind that decision may have regional/local
implications. Recognizes cross-function interdependencies
of decision. May challenge decisions where precedents have been set and
communicates rationale with stakeholders to gain consensus. Supports
the success of a high-performing business office by helping to champion and
drive long term success, achieving results comparable to national best
practices. Achieves highest standard of customer service while
maximizing resolution of balances due. This position will be based out of
Morgantown, WV.
MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1.
Bachelors
Degree
EXPERIENCE:
1.
5
years management experience required
2.
Five
(5) years of experience in healthcare finance
PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1.
Bachelors
Degree in Accounting, Finance, or Business
2.
Masters
Degree, Certified Healthcare Financial Professional (CHFP) of HFMA
EXPERIENCE:
1.
Experience
developing standards, processes, policies and procedures for a diverse organization
2.
Record
of success managing complex projects with multiple, diverse stakeholders.
3.
Prior
experience with Epics Hospital Billing module
4.
Experience
working in an organization of size and complexity comparable to WVU Medicine.
CORE
DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the
general nature of work being performed by people assigned to this position.
They are not intended to be constructed as an all-inclusive list of all
responsibilities and duties. Other duties may be assigned.
1.
Senior
position over billing processes for WVU Medicines professional billing
function. Assures the accurate and timely billing and collection of
professional revenue by managing billing, collections, and other support
areas to these integrated functions for all professional providers practicing
at sites throughout West Virginia and surrounding
communities.
2.
Directly
supervises a team of Patient Financial Services
Managers.
3.
Provides
strategic leadership to patient financial services department through
innovative ideas, reasoned risk taking, and thoughtful and thorough
implementation strategies.
4.
Reduce
denials through analysis of payer behavior and billing processes to best
practice levels.
5.
Interprets
and communicates healthcare payment policies and practices and devises
strategies to maximize reimbursement to maintain cash flow at established
levels.
6.
Analyzes
financial policies and procedures as they relate to patient financial
services and implements changes to achieve best practice levels for revenue
cycle metrics.
7.
Assures
cost reimbursement criteria followed and maintained to ensure correct
reporting and cost reimbursement. Ensures close cooperation, planning and
strategic alliances with all areas affecting reimbursement outcomes.
8.
Continually
monitors and optimizes service functions based on changing environment and
customer requirements.
9.
Maintains
system level patient collection policies that are compliant with State and
Federal regulations.
10.
Analyzes
and manages accounts receivable variables that are very complex due to
constantly changing rules and regulations imposed by managed care companies,
third party payers, and governmental agencies. Develops payer
relationships to assist in resolution of complex payment and billing issues
as they arise.
11.
Writes,
interprets, adapts and enforces organizational and departmental policies as
needed with management, employees and third party payers and customers.
12.
Ensures
financial reporting for state, federal and hospital record keeping and
reporting regulations are met.
13.
Provides
support and advice on the design and practically of HMO, PPO, etc. billing
arrangements, collection procedures, and compliance of managed care
contracts.
14.
Functions
as primary resource for all professional Patient Financial Services decisions
for information technology, patient access, medical records, utilization
management, ancillary revenue departments, etc. for the WVU Medicine
enterprise.
15.
Plans
and sets goals with all related areas to ensure decisions are optimal for
organizational goals and consistent with missions, administrative philosophy
and guidelines.
16.
Ensures
physician relationships are developed and maintained to reflect collaborative
environments.
17.
Sets
goals and standards with leadership team to ensure standardization, quality,
and timeliness of patient financial services operations throughout the
system.
18.
Ensures
that local and regional issues are resolved in a timely manner and
consistently with the operations of other regions within the system.
19.
Acts
as a primary conduit for the EPIC PB module, ensuring that all system
implications of change requests are reviewed keeping local and regional
impacts in mind at all times.
20.
Serves
as representative of department and team within the organization. Integrates
department operations into clinical operations where needed.
21.
Manages
cash posting, refunds and cash reconciliation for all sites to ensure
efficient and accurate posting of cash and reconciliation of cash to bank
deposits.
22.
Ensures
employee evaluations are objective, address employee performance and
timely.
23.
Prepares
and administers annual operating and capital budgets for department,
reporting variances where required.
24.
Responsible
for managing billing and customer service functions for any contract billing
functions within the department.
PHYSICAL
REQUIREMENTS: The physical demands described here are representative of those
that must be met by an employee to successfully perform the essential
functions of this job. Reasonable accommodations may be made to enable
individuals with disabilities to perform the essential functions.
WORKING ENVIRONMENT: The work environment
characteristics described here are representative of those an employee
encounters while performing the essential functions of this job. Reasonable
accommodations may be made to enable individuals with disabilities to perform
the essential functions.
1.
Office
work which includes sitting for extended periods of time
2.
Travel
to all business office sites required
SKILLS
AND ABILITIES:
1.
Must have
strong oral, written and analytical abilities.
2.
Must be able
to supervise personnel to effectively represent the department and hospital
in interactions with payers, patients, physicians and other departments.
3.
Must also
have ability to perform a variety of duties, ranging from direct involvement
in various procedures to coordination of activities of many subordinates.
4.
Experience
with Microsoft Office required.
5.
Experience
with EPIC or similar system preferred.
6.
Experience
managing complex/ large scale/ transformational projects, including
demonstrated success in coordinating major projects.
7.
Experience
developing standards, processes, policies, procedures and service level
agreements.
8.
Demonstrates
leadership in planning new or expanded services, managing projects and
coordinating multi-department task forces.
9.
Demonstrates
mastery in Patient Financial Services
10.
Understanding
and experience with performance metrics.
11.
Ability to
establish, develop and manage collaborative professional relationships.
12.
Experience
developing and managing department budgets.
13.
Aptitude to conceptualize,
plan, and implement stated goals and objectives.
Date
Reviewed/Revised: January 2022
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