Manager Patient Financial Services- Government Billing

Job Description:
Under the general direction of the Senior Director-Patient Financial Services, and in conjunction with objectives set by the Vice President-Revenue Cycle, is responsible for the oversight and coordination of improvement projects and initiatives in Patient Financial Services. Works collaboratively with senior leadership to identify and develop opportunities to transform processes, improve productivity, and reduce costs while ensuring that these changes do not have an unintended negative impact to quality outcomes, patient satisfaction or employee satisfaction. Develops effective leading and lagging indicators of performance that are clearly defined and can be relied upon to effectively track improvement while ensuring no adverse impact to operations. Responsible for developing targets and goals for achievement each fiscal year that ensure the overall success of operation. Responsible to work collaboratively with the finance planning team to ensure that the targets and goals of Patient Financial Services Stewardship program are appropriately integrated into the system's budget so that there is a clear understanding and engagement across the organization to align efforts to drive to the desired outcomes. Works effectively with the Analytics team to develop data sets needed to track and measure progress towards targets. Responsible for the development of effective and insightful dashboards and analytics that clearly show the success of the Stewardship initiative in the achievement of targets and goals. Responsible to work discretely and collaboratively with a variety of leaders from different operational areas in the organization to complete these tasks in an effective, cohesive and comprehensive way. Understanding that all transactions potentially have an impact to the overall operation of the organization, this position must stay aware of changes that could impact success of the Stewardship initiative and continuously adapt and work with leaders to account for any impact of these changes. Manages, supervises and develops reporting staff.
Duties and Responsibilities

1. Partners with senior leaders to understand current operations and identify opportunities for improvement and transformation that should be included in the Stewardship program to support the journey to value that will make WellSpan thrive for years to come.
2. Assists with Patient Financial Services strategic plans, process improvement, reimbursement, and denial management strategies in line with system goals. Works with project teams in the analysis, design, and implementation of Revenue cycle projects.
3. Utilizes & analyzes data available in EPIC and other Access based tools to drive Revenue cycle work to focus on high priorities
4. Provides Revenue Cycle support to Patient Financial Services, promoting strong cooperation and alignment with Contract Management, Patient Access, Coding, and other System entities.
5. Identifies and implements process/workflow redesign when appropriate to increase efficiencies, reduce waste (denials and adjustments), limit variation and improve Revenue cycle outcomes.
6. Monitors industry and organizational changes for opportunities and impacts to achievement of goals and plans and effectively adapts the Stewardship program, in conjunction with leadership, to ensure that the organization can continue to achieve the objectives of the program.
7. Collaborating with the Analytics team creates data sets, dashboards and analytic assets that clearly communicate the success of the Stewardship program.
8. Works discretely and collaboratively with senior leadership to perform strategic analysis of organizational opportunities as well as the development of process improvement programs that support the overall transformational goals of the Stewardship program.
9. Effectively communicates, to all levels of the organization, the purpose, goals, successes and challenges of the Stewardship program.
10. Participates in various ad-hoc Patient Financial analysis projects as assigned.

Qualifications

• Minimum Experience:
  • Minimum 8 years progressive experience in health care finance, including specialized experience with analytics, performance improvement, change management and project management.
  • Experience with traditional Medicaid/Medicare billing and regulations
  • Experience with Medicare/Medicaid Advantage billing and follow up
  • Experience in claim/edit resolution
  • Experience in Payor Rejection resolution
  • Experience with A/R mgmt.
  • Experience with Denial Mgmt and resolution

• Minimum Education:
  • Bachelor's Degree

• Minimum Field Of Expertise:
  • Financial Analysis of hospital and medical group operations. In depth understanding of Revenue cycle and integrated health system operations, leading and lagging performance metrics that are critical to identifying opportunities to influence change in the organization. Understanding of data, analytics and presentations to tell the story of what is happening in an organization.
  • Epic experience a major plus

• Preferred Education:
  • Master's Degree

• Preferred Certification:
  • Healthcare/Business/Finance