Manager, Patient Financial Counseling

Position: Manager, Patient Financial Counseling

Department: Financial Counseling

Schedule: Full Time

POSITION SUMMARY:

Under the general direction of the PFS Director, the MPFS develops departmental policy and manages the billing, collection, follow-up, vendor management, and customer service units; coordinates team resources and activities to ensure HB Revenue cycle meets department KPIs and goals; produces and analyzes reports to identify trend analysis and process gaps; identifies and resolves problems for maximum revenue and cash flow to Boston Medical Center. Within the appropriate scope of responsibility and span of control, the MPFS grounds all department activities to help BMC meet its core purpose:

Exceptional Care, without exception. Furthermore, the MPFS supports and exhibits BMC's three core values: built on respect and empowered by empathy; moves mountains; and many faces create our greatness.

JOB REQUIREMENTS

EDUCATION:

Knowledge of accounting, finance, and business management, hospital administration or related field; and ability to prepare clear and comprehensive oral and written communications at a level generally acquired through completion of a Bachelor's degree in accounting, business or financial management or related field required, MBA preferred.

EXPERIENCE:

Requires an extensive knowledge of policies, procedures, systems and equipment relating to revenue cycle operations; of regulations and guidelines pertaining to third-party payers and self-pay patients; of Microsoft Office suite; of supervisory techniques and performance management at a level generally acquired through seven to ten years of experience of which (7) must have been in a supervisory capacity.

Requires the ability to develop policies, procedures, processes and programs; to maintain a budget and monitor expenditures in compliance with budgetary guidelines; to analyze data and interpret statistics; to create a variety of narrative, statistical, and budgetary reports, including trend analysis; to identify and resolve problems; and to interpret guidelines and regulations

KNOWLEDGE AND SKILLS:

Work requires interpersonal skills necessary to provide leadership in team building endeavors; to collaborate with other managers and directors in support of hospital and departmental goals and objectives; to establish and maintain effective, cooperative working relationships with employees and managers; to act as a liaison to third-party representatives and represent the hospital's interests while negotiating and obtaining contracts; and to train employees.

ESSENTIAL RESPONSIBILITIES / DUTIES:

General management responsibilities

Manages and coordinates the activities of the HB PFS and vendor liaison teams to achieve departmental goals for cash collection, lowering insurance and patient account receivables, and reducing bad debt. Sets daily goals and targets, motivates and supports staff to meet those targets. Interacts with BMC departments and payer representatives to address account resolution barriers.

Develops programs, policies, processes and procedures for meeting KPIs and achieving short and long-term goals. Documents processes among important internal customers (including but not limited to, Case Management, Patient Access, Registration, Coding, outside vendors), identifies gaps, and recommends changes in policies, processes and procedures to address operational needs and to ensure continuous quality improvement.

Consistently manages PFS activities to meet federal, state, and third-party payer regulations and guidelines. Oversees department activities to meet goals by specified target dates. Holds regularly scheduled staff meetings and daily huddles to convey information and motivate staff.

Develops and maintains productivity and quality measurements and adjusts resources to meet hospital and departmental standards. Demonstrates problem-solving solutions and initiates changes as required.

Sets daily direction and reviews team assignments with supervisors. Develops, monitors, and uses reporting tools, monthly reports, and analyses for management.

Demonstrates ability to identify and resolve interpersonal or professional conflicts when dealing with the BMC community and external customers (vendors, payers and others). Investigates and responds appropriately to all complaints and takes effective actions to resolve issues.

Responsible for effective fiscal management of department operations. Assists the Director in developing and monitoring budgets.

Effectively manages financial resources within the established annual budget. Explains and documents justification for budget variances. Investigates and suggests alternatives to the established budget depending on shifting demands of resources.

Human Resources, employee retention, training and staff development

Responsible for effective human resource management within the Patient Financial Services Department. Consistently and fairly interprets and enforces human resource policies.

Maintains effective and appropriate staffing and ensures effective hiring processes. Selects qualified employees according to Human Resource policy and employee-relations laws and guidelines.

Conducts employee disciplinary procedures up to and including termination with appropriate documentation according to Human Resources policy and employee-relations laws and guidelines. Monitors employee turnover, overtime and absenteeism.

Ensures on-going training for employees to respond to evolving business and staff needs and challenges. Develops training materials for management of department-specific content.

Establishes and delivers PFS training modules and competencies. Performs a training needs analysis annually to target continuing training needs for Director's review. Ensures all staff are appropriately trained and have completed annual training as required by BMC (for example, safety and infection control).

Systems, analysis and reporting

Analyzes data and produces reports to identify areas of focus, account resolution, and the overall effectiveness and efficiency of the unit. Collects accurate and timely information and creates reports that highlight activity trends.

Analyzes trends and interprets results. Identifies, reports, and resolves issues relating to all revenue cycle IT platforms (including but not limited to Epic, NThrive, Medicare FISS, Trizetto, and HealthRise). Reviews operations and uses data to determine overall performance, team performance, error rates, system disconnects, etc. Prepares ad hoc and standard reports to communicate interpretational analysis. Recommends solutions to problems using existing resources in compliance with budgetary constraints.

Acts as resource person on changes in billing regulations and systems procedures and provides technical expertise for all applicable BMC Revenue Cycle and payer systems.

Professional use of self and personal development

Consistently demonstrates tact, courtesy and a positive attitude in communication and interaction with all internal and external customers. Collaborates to resolve issues and concerns relative to service quality, systems, and other identified problems.

Represents the department at meetings and on committees. Participates in the decision and policy-making process on hospital-wide issues, particularly those which relate to PFS activities, as assigned. Represents the department and the hospital in a positive manner. Responsible for communication within the Patient Financial Services area to ensure information is shared for effective operations.

Demonstrates professional and focused, written and verbal communication at all times and in all interactions. Demonstrates and models the AIDET framework in appropriate context and interactions.

Responsible for professional development to ensure appropriate knowledge of systems and advances in the administration of billing and collection activities. Attends seminars and reads reports and publications issued by regulatory agencies, third-party payers, etc., to maintain and display appropriate knowledge of developments to the regulatory environment and billing and collecting activities.

Identifies personal and professional areas for improvement and actively seeks out ways to meet developmental needs. Uses hospital's Core Purposes and Values as the basis for decision making and to facilitate PFS's contribution to BMC's mission. IND123

Equal Opportunity Employer/Disabled/Veterans