Insight Global is looking for a Director of Patient Financial supporting a large hospital system in Annapolis, MD. The Director of Patient Financial Services (PFS) is responsible for the management of PFS functions of the Medical Center. This leadership position ensures processes, workflows and staffing infrastructure is optimized to achieve optimal results in cash collections and industry leading A/R metrics.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:
-Ensures timely, complete, and accurate generation of claims. Ensures all staff and management responsible for claim submission are versed in LCDs, CCI edits and all relevant billing rules and regulations.
-Maintains a clear and consistent claim follow-up workflow to identify, address and mitigate denials.
-Responsible for the PFS denial workflow ensuring the appropriate dissemination of denial work to internal PFS staff, external vendor/attorneys and/or the respective internal clinical staff to address claim denials.
-Manages a team of customer service representatives ensuring optimal customer service
-Responsible for all PFS related cash management functions
Is responsible for maintaining payer level detail supporting payer advances and performs validation of adjustments to payer advances
-Maintains clear and current vendor summary information including, but not limited to, monthly performance activity by vendor, expenses incurred, and evaluates performance to determine effectiveness of vendor. Makes recommendations for adjustments, as needed.
-Responsible for the cashiering function including the workflow, process and related internal controls.
-Oversees the patient advocacy process to secure applicable coverage for uninsured patients. Coordinates internal advocacy efforts with external contracted vendors to achieve a comprehensive process ensuring coverage to uninsured patients. Maintains performance information to report on advocacy efforts.
-Responsible for the pre-registration and financial clearance function to secure complete and accurate information.
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