Director, Patient Business Services

Primarily responsible for all aspects of the Patient Business Services (PBS) in Kalispell Regional Medical Center. Ensures that PBS personnel are adhering to the philosophy, policies, procedures, goals and budgets of the office and Kalispell Regional Healthcare (KRH) in performing all steps of the revenue cycle to include, but not limited to, patient access, authorizations, charge capture, claim submission, billing, payment posting, accounts receivable functions, collections, denial management and customer follow-up. Ensure exceptional customer service and solid understanding of State and Federal regulations and requirements to assure compliance.

Qualifications:
1. Bachelor’s degree with Master’s preferred and minimum of six years management experience leading teams, with three years managing at a Director level preferred.

2. Comprehensive knowledge of reimbursement regulations for Medicare, Medicaid and other third party payors as relevant to KRH operations required.

3. Ability to communicate effectively, both written and verbally, take initiative, exercise independent judgment and problem-solve; ability to work effectively with staff, public and external agencies; possess skills in planning, organizing, delegating, supervising and interpreting data.

4. Skilled in researching, preparing and presenting comprehensive reports resulting in executive decisions.

5. Familiarity with basic budgeting processes and ability to master budgeting skills.

6. Three – five years of experience working with and improving revenue cycle process.

7. Knowledge of organizational policies, procedures and systems; knowledge of health care administration practices; knowledge of computer systems and medical software and applications. Knowledge of HIPAA and ERISA guidelines.

8. Ability to utilize Microsoft Office programs such as Word, PowerPoint, Excel and Outlook.

Experience with Meditech software platform preferred or five years of billing system or EMR use. Possess a strong aptitude for learning and using new information systems.

Management Job Duties:
1. *Decision Making/ Judgment: Analyze problems or procedures, evaluate alternatives and select best course of action; use of logic and commonly accepted practices in decision making to ensure timely effective solutions.

2. *Human Resources: Create a supportive department culture by fostering individual motivation, coaching and training for optimum job performance. Collaborate with Human Resources to ensure each employee has the required and appropriate license and certification(s). Give direction without conflict. Anticipate staff problems and take preventive measures. Analyze and respond to employee turnover taking appropriate steps to maintain high employee morale and satisfaction. Educate employees on timekeeping policies and procedures to ensure accuracy. Review and approve the bi-weekly payroll for department employees. Responsible for completing 6-month and annual performance evaluations with employees on or before their due date for all employees supervised by the unit manager. Create job descriptions and job standards for each position and monitor to ensure accuracy. Plan work schedules and assign work to staff to ensure adequate service and coverage.

3. *Communication: Effectively share information, build relationships and influence positive outcomes. Demonstrate good collaboration, listening skills and effective verbal and written communication skills. Communicate clear and measurable expectations and participates in corrective actions as needed.

4. *Fiscal/ Productivity: Assist in the development of annual departmental operations and budgets. Monitor expenditures within budgetary guidelines, analyze variances and make appropriate adjustments. Demonstrate cost containment with all resources.

Other Job Duties:
1. *Lead, manage, direct and coordinate staff of trained personnel in all aspects and steps of the healthcare revenue cycle from claim submission to arriving at a patient zero balance.

2. *Establishes or delegates implementation of goals, objectives, policies, procedures and systems for each area of revenue cycle within PBS.

3. * Establishes, populates and manages metrics to measure goal attainment in all major aspects of the revenue cycle to include, but not limited to, access authorization, POS payment collection, clean claim submission (demographics) to billing department, claim submission, collection rate and accounts receivable.

4. * Ensure that all PBS patients receive optimum customer service as they interact with staff while traversing our revenue cycle.

5. * Institute and monitor proper procedures to ensure best communication between all parties responsible for aspects of the PBS revenue cycle.

6. * Responsible for direction and oversight of all PBS operations via the PBS Operations Manager, Patient Access Manager and his/or staff.

7. Participate in the PBS budget processes as necessary to ensure all aspects of the PBS revenue cycle are properly resourced.

8. * Work with Executive Director of Revenue Cycle and hospital administration to ensure the highest standards of revenue cycle business performance by participating in the KRHS Revenue Cycle Improvement Workgroup as needed.

9. *Monitor and provide statistical reporting, implement necessary changes to comply with the budget, maximize revenues, maintain adequate cash flow and ensure compliance with all applicable government regulations.

10. *Responsible for the evaluation, development, implementation and revision of policies and procedures related to revenue cycle activities. Support confidentiality and follow standard accounting procedures within all departmental operations. Assure timely and accurate billing and collecting practices. Review departmental goals and objectives; establish methods for evaluating effectiveness of resource utilization in all aspects of the revenue cycle.