Position Objective:

The Patient Financial Services  Manager is responsible for the management and execution of PFS staff and functions.  This position manages the day-to-day processes of department operations and ensures optimal workflow, appropriate training of staff, monitors performance for optimal outcomes, and makes recommendations for performance improvement, as needed. The Manager maximizes the effectiveness of Claims Submission, Insurance Follow-up, Insurance Validation, Denials Management, Financial Counseling, Collections, Cash Posting and Cashiering. The PFS Senior Manager ensures compliance with reimbursement requirements and ensures appropriate interpretation of Medicare, state and federal billing regulations. The Senior Manager leads the recruitment, retention and enrichment of PFS staff.

Essential Job Duties:

Reasonable accommodations may be made to enable individuals with disabilities to performthe essential functions.

Actively adheres to regulatory and governmental agency requirements regarding billing and reimbursement. Implements and remains current on regulatory updates and changes in a proactive manner.Mentors and develops the leadership team in the Patient Financial Services department.  Leads by example, maintains a professional demeanor, provides clear direction and goal setting, manages by metrics, and ensures full accountability of self and team members.Represents the PFS department in leadership meetings to provide subject matter / billing guidance in support of various strategic initiatives, IT system development initiatives, and other related opportunities.  Assumes lead role in various revenue cycle initiatives to advance the PFS or organizational goals. Actively participates in financial management related seminars or organizations to bring best practice opportunities to Luminis.Manages accounts receivable and billing trends. Oversees billing operation including control of unbilled and unprinted receivables and ensures that all billing meets third party payor's clean claims requirements and billing statutes. Identifies opportunities for improvement in current processes and procedures. Prepares analysis of revenue, cash, denials and receivables trends and implements changes as needed to improve the health system's revenue cycle metrics. Analyzes and reports data to various internal and external counterparts to demonstrate accounts receivable and compliance impact.Performs routine audits to ensure compliance with Luminis and PFS policies and procedures and manages corrective actions in timely and compliant manner.Resolves patient complaints escalated to the Manager level from PFS staff, PFS Supervisors, and the Patient Advocacy Department and keeps senior leadership abreast of issues.Protects hospital from denials, inappropriate granting of financial assistance and unnecessary bad debt by implementing frontend processes to help patients understand the extent of their financial responsibility and assist with application for available state, federal and AAMC internal programs.Act as liaison with third party payors, vendors and auditors. Actively participates in activities designed to motivate and enrich industry-wide knowledge at Luminis and PFS department.  Achieves the Support Services Satisfaction goal assigned to the PFS Department.Works with HIM, Revenue Integrity and revenue departments to ensure the DNB (Discharged Not Billed) is within established parameters.Maximizes available systems resources to the fullest extent to improve staff productivity, compliance and accounts receivable performance. Maintains system dictionaries in manner which promotes access to financial and other PFS related statistics. Works closely with management and information systems counterparts to implement and maintain sound application of state of the art technology.

Educational/Experience Requirements:

Five years of experience in Medical Billing, Central Business Office ,Hospital Patient Access, or  Hospital Business Office in an automated setting Minimum three-five supervisory experience in healthcare business office or similar setting.Minimum of three-five years demonstrated strong analytical skillsBachelor’s Degree required.Excellent verbal and written communication skills.Preferred experience with the Epic Hospital Billing System

Required License/Certifications:

Preferred CRCP or CHFP certification.

Working Conditions, Equipment, Physical Demands:

There is a reasonable expectation that employees in this position will not be exposed to blood-borne pathogens.

Physical Demands -

The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.

The above job description is an overview of the functions and requirements for this position.  This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.

Luminis Health Leadership Benefits Overview:

•             Medical, Dental, and Vision Insurance

•             Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year)

•             Paid Time Off

•             Tuition Assistance Benefits

•             Employee Referral Bonus Program

•             Performance Based – Leadership Variable Pay Program

•             Paid Holidays, Disability, and Life/AD&D for full-time employees

•             Wellness Programs

•             Employee Assistance Programs and more

*Benefit offerings based on employment status