General Summary

Directs, plans, organizes, and controls the integration of all WellSpan Health billing activities and functions related to Hospital and Ambulatory Services or Specialty Services. Provides operational oversight as needed. Achieves Patient Financial Services (PFS) Key Performance Indicator (KPI) goals through effective work queue management, dashboard performance monitoring, and strong employee engagement.

Duties and Responsibilities

Responsible for the oversight of Hospital and Ambulatory or Specialty billing and follow up of claims for Government and Non-Government and/or contracted and non-contracted payors. Ensures all regulatory guidelines are being met in all phases of the Billing cycle. Monitors productivity and work standards and ensures productivity is within acceptable ranges. This includes the analysis of all work queue volumes and staff productivity reports in accordance with dashboard management and productivity standards. Provides direction and oversight to the PFS Billing Managers in daily work queue activity and assists with review and analysis of billing reports on a daily/weekly/monthly basis to minimize CFB days and ensure timely filing. Actively works to identify and eliminate waste and inefficiency in people, processes, and systems by directing activities related to payments, allowances, and rejected / denied claims. Defines development objectives for staff and promotes/organizes in-service workshops and external educational opportunities for Team development. Assists the Senior Director in the development, implementation, and analysis of protocol standards/work methodology consistent with industry trends and departmental objectives. Research policies/procedures for non-government and government or specialty payers. Identifies and directs the changes to established workflows consistent with the payer policies/procedures and/or state and federal regulations to ensure accurate billing and correct reimbursement Proactively identifies opportunities for improvement, takes ownership, and works towards solutions and compromises that take the needs of all parties into account when conflict arise. Acts on behalf of the Sr Director as needed and serves as a liaison between PFS and other departments to ensure a consistent flow of information. Assists with system conversion and integration activities for current and future acquisitions. Generates billing reports, analyzes same and makes data-driven financial decisions in alignment with Revenue Cycle KPI goals and WellSpan's longer-term goals. Provides education and direction to revenue leaders as needed.

Common Expectations:

Builds capability through proactive selection and assignment and routine evaluation of staff performance; provides necessary tools, support training and continuing education, and governance actions for staff development and growth opportunities. Coordinates and integrates services within the department/organization, with other departments/service lines/entities, and with the System's primary functions. Participates in the selection of outside services (if needed). Continuously assesses and improves the department/System's performance. Maintains appropriate quality control/ assessment programs (if applicable). Develops, establishes, and implements goals, objectives, and policies and procedures for department/system operations, and which guide and support the provision of the department/system's services. Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise. Assists in annual budget preparation.

Qualifications

Minimum Education:

Bachelors Degree Required

Work Experience:

5 years minimum experience in Patient Financial Services, Accounting, or Business Administration experience; Leadership and Supervisory experience Required 1 year minimum experience in Specialty - Behavioral Health or Ambulance or Durable Medical Equipment billing (if assigned to oversee Specialty billing) Preferred

Licenses:

Certified Revenue Cycle Executive Upon Hire Preferred

Courses and Training:

HFMA Equivalent (if assigned to oversee Hospital and Ambulatory billing) Upon Hire Required You’re unique and you belong here.

At WellSpan Health, we are committed to treating all applicants fairly and equitably, regardless of their job classification. If you require assistance or accommodation due to a disability, please reach out to us via email at . We will evaluate requests for accommodation on a case-by-case basis. Please note that we will only respond to inquiries related to reasonable accommodation from this email address. Rest assured, all requests for assistance or accommodation are handled confidentially, allowing applicants to share their needs openly and honestly with us.