The Director, Hospital Business Office reports to the Vice President of Revenue Cycle. This position is responsible for daily oversight, management, and direction of the Billing, Collections, Cash-Posting, Charge-Posting and Customer Service areas of revenue cycle operations. The Director develops and communicates expectations of the organization to employees, provides resources, and acts to remove barriers to successful operations of the business office and all revenue cycle services; collaborates with physician business office; and ensures that regulatory requirements and standards are met.
- Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
- Excellence in clinical care, service and communication
- Collaborative within our institution and with others who share our mission and goals
- Leadership that set the standard for pediatric health care today and innovations of the future
- Accountability to our patients, community and each other for providing the best in the most cost-effective way.
- Assists Vice President, Revenue Cycle to develop Hospital Patient Financial Services (PFS) strategy. Develops and implements policies and procedures necessary for the daily operations of the business office that adhere to established facility policies. Develops key performance indicators (KPI) and follows through by monitoring qualitative and quantitative performance to ensure achievement of targeted financial and non-financial goals. Monitors and reports on key metrics, such as cash collections, days outstanding, unbilled, denials, etc., in conjunction with the Vice President, Revenue Cycle and other finance leadership.
- Plans, directs, manages, and evaluates effectiveness and efficiency of charge-entry, billing, and collections operations to ensure timely billing and collection of patient charges. Monitors bad debt and contractual losses against budget and compliance with established hospital policies.
- Establishes adequate controls to ensure patient service revenue is billed to third party carriers, government programs, and patients timely and accurately. Reviews write-off lists, refund requests, and miscellaneous cash adjustments. Identifies issues and focuses on timely implementation of appropriate corrective measures and procedures.
- Directs, manages, and evaluates effectiveness and efficiency of the customer service area of revenue cycle operations. Ensures patient complaints and problems are resolved in a timely manner and follow-up action taken as required. Facilitates dialogue between patients, physicians, nurses and administrative managers to resolve patient complaints. Refers complaints of a serious nature to Risk Management and conducts follow-up on their analysis.
- Establishes and maintains controls for all cash collected and posted in the patient accounting system. Recommends and implements changes where appropriate after thoughtful and measurable analysis.
- Collaborates closely with Patient Access, Managed Care, Decision Support and Finance to achieve revenue cycle improvements and desired financial goals; collaborates with physician business office management. Maintains effective communication with third party insurance carriers to resolve issues that impede cash flow and detract from patient/member satisfaction; manages vendor relationships. Maintains effective communication with PCH leadership to ensure that all third party compliance guidelines are met.
- Develops clear business plans and project plans as required. Effectively manages projects to ensure timely achievement of objectives. Maintains excellent patient, physician, and vendor relationships through proactive customer service oriented approach. Resolves issues between parties. Refers major issues and provides feedback, analysis and insight to Vice President, Revenue Cycle.
- Develops and manages staff through provision of timely feedback and use of appropriate Human Resource policies and tools to facilitate and ensure the ability of the staff to achieve highest level of professional growth and desired performance standards. Makes personal growth and development a priority by facilitating the professional growth of staff by accurately assessing learning needs, styles, and barriers to learning and coordinating learning opportunities in conjunction with education staff. Demonstrates ability to motivate subordinates and peers to complete assigned responsibilities and achieve established goals.
- Oversees the overall performance of AMPFM or related automated revenue applications. Actively directs system enhancement opportunities and directs new system implementations to ensure that business processes are positively impacted.
- Performs miscellaneous job related duties as requested.