Manager, Patient Financial Services - Hospital Revenue Cycle

US104 Guidehouse Managed Services LLC; San Marcos (CA); On-site; USD 85,000 - 141,000; Full time

Benefits offered by this job

Medical

Dental & Vision Insurance

401(k) Retirement Plan

Personal and Family Sick Time & Paid H

Parental Leave

Tuition Reimbursement

Skills Development & Certifications

Employee Referral Program

Job summary

Guidehouse in San Marcos, CA is seeking a Patient Financial Service Manager – Hospital Revenue Cycle to lead the PFS staff in billing, cash posting and collections. This full-time, on-site role requires ensuring accurate CPT4/HCPCS coding, regulatory compliance, and timely reporting.

You will supervise a team, drive process improvements, and partner with clinical and IT departments to optimize revenue cycle performance and payer relations.

Qualifications

• Requires a bachelor’s degree with 7+ years of healthcare revenue cycle experience.
• Experience leading a PFS team in billing, cash posting, and collections.
• Strong knowledge of CPT4, HCPCS, and Revenue Codes.
• Ability to interpret State and Federal rules and HIPAA.
• Must have at least two years of people management.

Responsibilities

• Supervises PFS staff in daily billing operations.
• Leads Billing, Cash Posting, and Collections processes.
• Ensures compliance reporting and KPI tracking.
• Collaborates with IT and payer teams to resolve issues.
• Produces daily, weekly, and monthly performance reports.

Skills

Leadership

Billing & Collections

Compliance

Training

People management

Healthcare revenue cycle

AR analysis

Education

Bachelor’s degree

AA degree

Job description

Job Family: PFS General Travel Required: Up to 10% Clearance Required: None

What You Will Do:

The Patient Financial Service Manager – Hospital Revenue Cycle is responsible for supervising the PFS staff in a fair and consistent manner on daily operations of billing, cash posting, and collections. Also performs any and all related job duties as assigned. This is a full time position working onsite Monday through Friday in the San Marcos, CA business office.

Essential Job Functions:

• Leadership / Training
• Billing / Cash Posting / Collections
• Compliance Reporting

Duties and Responsibilities:

• Acts and leads in a manner that will instill trust and foster team play.
• Ensures that all employees know and understand all State and Federal Rules and Regulations.
• Ability to make good judgment and quick decisions, strong AR acumen
• Provide a working environment which allows employees to communicate ideas for improvement to department.
• Whenever possible request employee input on policies and procedures that may affect or impact the way their job is performed.
• Maintain open communications and provide appropriate feed back to PBA staff and management.
• Allow employees to attend seminars which will enhance productivity and knowledge.
• Ensures employees have all the tools necessary to achieve the goals set.
• Billing/Cash Posting/Collections: Experienced in driving cash and AR account resolution. Working with all payers for resolution and escalation. Experienced with expected reimbursement variance management.
• Works with all departments to ensure accuracy of CPT4, HCPCS and Revenue Codes.
• Provide departments with Medicare and other payer updates, notices and coverage changes which effect both billing and reimbursement.
• Reviews process and systems to ensure the most effective methods are maintained to meet all departmental and facility goals.
• Works with IT to ensure that all changes are completed to ensure accuracy of billing is maintained.
• Ensures bill hold in electronic systems meets established goal.
• Works with both electronic billing vendor and payers to resolve billing/cash posting issues.
• Identifies and resolves problems in the patient accounts receivable process and when appropriate initiate changes to rectify payer issues, underpayments and denials.
• Reviews and approves credit arrangements, refunds, write-offs and adjustments on accounts and insures departmental and medical center policy regarding signature levels are followed.
• Manages all employees providing follow-up on third party and self-pay accounts post initial billing.
• Prepares, distributes, and presents daily, weekly, and monthly reporting packages as required.
• Monitors overall performance and productivity in department.
• Ensures all reports are completed timely.
• Acts as a technical resource for Medicare regulations and reimbursement.
• Ensures that all components of the Medicare Bad Debt Log and supporting documentation are complete.
• Oversees Completion of Bad Debt vendor reconciliation.
• Informs management of all compliance issues.
• Assigned special projects will be completed within the time frames given.
• Appropriately documents each account worked in patient accounting system.
• Ensures all established goals are met.
• Develops and executes projects to reduce aged A/R and enhance collections.
• Understand and manages client service level metrics and key indicators of revenue cycle performance.
• Develop and adhere to methods of KPI improvement.

Compliance:

• Communicates all compliance issues to Manager.
• Educates and ensures that all employees understand Compliance and appropriate procedure for reporting compliance issues for State, Federal and HIPAA.
• Attends pertinent seminars, internal and external and shares obtained information with staff and other appropriate departments.
• Reviews and maintain JACHO requirements for billing, cash posting and collections.

Reporting:

• Responsible for the weekly Key Indictor Reports Patient Accounting and Billing Scrubber reports to departments daily.
• Maintain logs by department for claims on hold status.
• Daily electronic and paper claim report.
• Other reports as requested by management.

What You Will Need:

• Requires a bachelor’s degree and a minimum 7 years or an AA degree and 9 years of prior relevant experience. (Relevant experience may be substituted for formal education or advanced degree.) Relevant experience coming from healthcare, business or professional settings.
• Of the seven years of relevant experience required, a minimum of two years must include people management experience.

What Would Be Nice To Have:

• Solid understanding of healthcare revenue cycle.
• Demonstrated competency in working in teams and ability to effectively communicate with all levels.

The annual salary range for this position is $85,000.00-$141,000.00.

Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• Medical
• Rx
• Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account
• Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.