DIRECTOR OF HOSPITAL PATIENT FINANCIAL SERVICES

Job Title

Director of Hospital Patient Financial Services (PFS)

Department

Patient Accounts/Business Office

Full Time/PRN

Full Time

Scope of Authority

The Director of Hospital Patient Financial Services is an executive-level position with direct supervisory authority over hospital patient financial services operations across multi facilities. This position carries full management responsibility for team performance, operational outcomes, financial performance, and compliance across the hospital patient financial services function. The Director has authority to make personnel decisions within established SCRMC policy and to implement operational changes within the scope of the department.

Job Summary

The Director of Hospital Patient Financial Services provides strategic, tactical, and operational leadership for hospital patient financial services. This position is accountable for the accuracy, compliance, productivity, financial integrity, and performance of hospital billing, accounts receivable, self-pay, collections, cash posting, payment processing, denial management, and account resolution, and serves as a key partner to clinical, financial, and administrative leadership in optimizing hospital revenue cycle outcomes.

The Director leads, develops, and manages patient financial services staff, including contract staff, and ensures that all hospital patient account functions are carried out in accordance with applicable regulatory requirements, payer guidelines, and SCRMC policies and standards.

Essential Duties & Responsibilities

• The following duties are representative of the functions performed in this role. This list is not exhaustive, and other duties may be assigned as needed.
• Lead and supervise hospital patient financial services operations, including staffing, performance management, coaching, budgeting, productivity, and staff development.
• Oversee accurate and timely hospital billing, claim submission, billing work queues, edits, rejections, payer requirements, and account resolution.
• Manage accounts receivable, cash flow, aging, payer follow-up, underpayments, denials, appeals, audits, and reimbursement issues.
• Direct self-pay, patient statements, financial assistance, payment plans, bad debt, refunds, and internal and external collection activities.
• Ensure accurate and timely cash posting, payment reconciliation, adjustment processing, and resolution of unapplied cash.
• Develop and maintain departmental policies, procedures, compliance protocols, and internal controls in accordance with payer, CMS, Medicaid, DNV, HIPAA, OIG, state and federal requirements, and SCRMC standards.
• Oversee required regulatory and financial reporting, documentation, audit responses, and corrective actions.
• Monitor key performance indicators and regulatory and payer changes, communicate updates, analyze trends and root causes, and implement improvements that increase collections, reduce A/R and denials, and improve accuracy and efficiency.
• Support implementation, optimization, and effective use of EMR and revenue cycle systems, reporting tools, system conversions, and operational workflows.
• Collaborate with Revenue Cycle leadership, clinical teams, and organizational departments to resolve issues, address documentation and reimbursement concerns, support strategic initiatives, report performance, and perform other assigned duties.

Minimum Qualifications

Education & Experience

• Bachelor's degree in Business Administration, Healthcare Administration, Finance, Accounting, Health Information Management, or a related field preferred
• Minimum of five (5) years of progressive experience in hospital patient financial services, healthcare revenue cycle management, progressive hospital billing, or a related healthcare financial function required
• Minimum of five (5) years of progressive long term care and skilled nursing facility billing experience preferred

Licensure / Certification

Revenue cycle, healthcare financial management, or related professional certification preferred

HFMA certification or other applicable healthcare revenue cycle certification preferred

Required Knowledge, Skills, & Abilities

• Comprehensive knowledge of the hospital revenue cycle, including billing, claims, accounts receivable, denials, self-pay, collections, payment posting, refunds, and account resolution
• Strong understanding of Medicare, Medicaid, commercial payer, CMS, and applicable state and federal billing requirements
• Strong knowledge of hospital reimbursement and payer adjudication processes
• Demonstrated ability to analyze financial and operational data and translate findings into measurable performance improvement
• Strong financial management and problem-solving skills
• Excellent oral and written communication skills, including the ability to communicate complex financial and operational issues to executive leadership
• Strong organizational skills with the ability to manage competing priorities and meet regulatory and financial deadlines
• Proficiency with electronic health records, patient accounting systems, revenue cycle platforms, Microsoft Office, and data reporting tools
• Knowledge of hospital contractual reimbursement, payment variance analysis, and underpayment identification

Preferred Skills & Competencies

• Experience with Epic Resolute Hospital Billing and/or Epic revenue cycle applications
• Experience managing a hospital Patient Financial Services department
• Experience with denial prevention and root-cause analysis
• Experience with revenue cycle dashboards, financial analytics, and productivity reporting

Physical Requirements

The physical demands and work environment described below are representative of those an employee must meet to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the position, in compliance with the Americans with Disabilities Act (ADA).

Physical Demands

• Primarily sedentary work requiring extended periods of sitting at a workstation
• Frequent use of hands and fingers to operate computers, keyboards, and standard office equipment
• Occasional standing, walking, and movement throughout the hospital and administrative areas
• Must be able to communicate clearly and effectively in person, by telephone, and in written form
• Specific vision requirements include close vision for reading printed and digital materials

Work Environment

• Work is performed primarily in an office setting within a hospital, clinic environment or business office
• Moderate noise level typical of an administrative healthcare setting
• May require occasional extended hours during peak billing periods, system implementations, audits, regulatory deadlines, or other operational needs
• All candidates must be able to perform the essential functions of this position. The American with Disabilities Act (ADA) requires that reasonable accommodations be made for qualified individuals to help perform the essential functions of the position.
• South Central Regional Medical Center is an equal opportunity employer and does not discriminate based on race, color, religion, sex, gender, national origin, age, disability, or genetic information.