PostJobMatches By WorkStaff USA
PostJobMatches By WorkStaff USA is a leading staffing agency in the job placement industry, providing top-notch professionals to facilities across the country. Our team of experienced recruiters work together to match the best candidates with the right job opportunities.
Today we are seeking an Assist Director-Commercial – Patient Financial Services for our client in Orange, CA. You will have scheduled work from home days as this is a Hybrid schedule, work from home 2-3 days a week.
Responsible for planning, directing, and managing all aspects of Accounts Receivables management for the Patient Financial Services department; including commercial, managed care, workers compensation, ERISA, self-funded and all other indemnity health plans. Ensures standards of unit operations are in compliance with all state and federal healthcare regulatory agencies. Participates on organizational performance improvement projects. Analyze denial trends and publish organizational reports to improve first pass yield. Incumbent has overall responsibility for training, unit performance, resolution of operational and personnel issues, evaluations, hiring, and disciplinary action. Serves as a role model and resource to colleagues, staff, and others. Interacts with all levels within the organization, including senior leaders, managers, directors as well as insurance companies, third party payers, vendors, and regulatory agencies.
Required Qualifications:
-Ability to motivate staff to achieve desired results
-Sound understanding of Joint Commission and other applicable regulatory requirements to be able to monitor for compliance
-Ability to maintain a work pace appropriate to the workload
-Excellent written and verbal communication skills in English
-Demonstrated experience building competency and developing skills of others
-Must have experience in working with contracts, applying terms and conditions to claims and performing split billing as required by Contracted Payers and DOFRs.
-Working knowledge of billing commercial claims, workers compensation, managed care and all other third party payers.
-Detailed understanding of billing technical elements such as standard forms and data elements, coordination of benefit and third-party liability billing and collection, electronic billing, data edit programs, reimbursement methodologies such as Diagnosis Related Groups (DRGs), Case Rate, Percent of Charges, capitation.
-Thorough knowledge of healthcare billing, finance and compliance and strong understanding of facility billing systems.
-Extensive knowledge of governmental compliance rules and issues as it pertains to health care billing, collection and other reimbursement.
-Self- directed and organized with superior analytical and problem-solving skills.
-Five (5) years’ experience in a revenue based, health care related industry such as admissions, registration, billing/collections or contracting
-Five (5) years’ experience in management of Patient Financial Services
-Experience in PFS Operations in an Academic Medical Center organization or complex teaching environment
-Working knowledge of billing, follow up and denial management of commercial claims, workers compensation, managed care and all other third-party payers.
-Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
-Bachelor’s Degree in related field
Preferred Qualifications:
-Masters degree in Health Care Management, Business, Finance or Accounting
-Experience in PFS Operations, University and medical center organizations, policies, procedures and forms
-Prior management experience of union-represented staff
-Knowledge of University and medical center organizations, policies, procedures and forms
Compensation
Base Salary – USD $90,500 to $167,700
Full-time
Benefits – Full
Relocation Assistance Available – No
Commission Compensation – No
Bonus Eligible – No
Overtime Eligible – No
Interview Travel Reimbursed No
Candidate Details
5+ to 7 years experience
Seniority Level – Mid-Senior
Management Experience Required – Yes
Minimum Education – Bachelor’s Degree
Willingness to Travel Never
Security Clearance Required: No
Visa Candidate Considered: No