Job Description:

Industry: Healthcare / Health Services - Hospital Administration

Job Category: Finance / Accounting - Corporate Finance

Position Summary:

Responsible for planning, directing, and managing all aspects of Accounts Receivables management for the Patient Financial Services department; including commercial, managed care, workers compensation, ERISA, self-funded and all other indemnity health plans. Ensures standards of unit operations are in compliance with all state and federal healthcare regulatory agencies. Participates on organizational performance improvement projects. Analyze denial trends and publish organizational reports to improve first pass yield. Incumbent has overall responsibility for training, unit performance, resolution of operational and personnel issues, evaluations, hiring, and disciplinary action. Serves as a role model and resource to colleagues, staff, and others. Interacts with all levels within the organization, including senior leaders, managers, directors as well as insurance companies, third party payers, vendors, and regulatory agencies.

Required Qualifications:

Ability to motivate staff to achieve desired results

Sound understanding of Joint Commission and other applicable regulatory requirements to be able to monitor for compliance

Ability to maintain a work pace appropriate to the workload

Excellent written and verbal communication skills in English

Demonstrated experience building competency and developing skills of others

Must have experience in working with contracts, applying terms and conditions to claims and performing split billing as required by Contracted Payers and DOFRs.

Working knowledge of billing commercial claims, workers compensation, managed care and all other third party payers.

Detailed understanding of billing technical elements such as standard forms and data elements, coordination of benefit and third party liability billing and collection, electronic billing, data edit programs, reimbursement methodologies such as Diagnosis Related Groups (DRGs), Case Rate, Percent of Charges, capitation.

Thorough knowledge of healthcare billing, finance and compliance and strong understanding of facility billing systems.

Extensive knowledge of governmental compliance rules and issues as it pertains to health care billing, collection and other reimbursement.

Self- directed and organized with superior analytical and problem-solving skills.

Five (5) years' experience in a revenue based, health care related industry such as admissions, registration, billing/collections or contracting

Five (5) years' experience in management of Patient Financial Services

Experience in PFS Operations in an Academic Medical Center organization or complex teaching environment

Working knowledge of billing, follow up and denial management of commercial claims, workers compensation, managed care and all other third party payers.

Must possess the skill, knowledge and ability essential to the successful performance of assigned duties

Bachelor's Degree in related field

Preferred Qualifications:

Master's degree in Health Care Management, Business, Finance or Accounting

Experience in PFS Operations, University and medical center organizations, policies, procedures and forms

Prior management experience of union-represented staff

Knowledge of University and medical center organizations, policies, procedures and forms

Security Clearance Required: No

Visa Candidate Considered: No

Compensation

Base Salary - USD $90,500 to $167,700

*** Never repost ***

Full-time

Benefits - Full

Relocation Assistance Available - No

Commission Compensation - No

Bonus Eligible - No

Overtime Eligible - No

Interview Travel Reimbursed - No

Candidate Details

5+ to 7 years experience

Seniority Level - Mid-Senior

Management Experience Required - Yes

Minimum Education - Bachelor's Degree

Willingness to Travel - Never

Screening Questions
Does candidate possess at least five (5) years' experience in a revenue based, health care related industry such as admissions, registration, billing/collections or contracting?
Does candidate possess at least five (5) years' experience in management of Patient Financial Services?
Does candidate possess experience in PFS Operations in an Academic Medical Center organization or complex teaching environment?

Ideal Candidate
All candidates submitted MUST meet at MINIMUM the required qualifications listed.
RELO is not authorized for this opening.

Position is NOT remote.

Why we're a great company

We are UCI Health: A devoted team of nationally regarded physicians and nurses, researchers and clinicians, educators and students united by a single calling - to improving the lives of the people in our community and beyond.

As the only academic health system in Orange County, our multifaceted organization is fiercely dedicated to the discovery of new medical frontiers, to the teaching of future healers and to the delivery of the finest evidence-based care.

We are unique in our ability to provide the most compassionate healthcare because we're driven by our passion for innovation, grounded in the best medical and scientific knowledge.

Our numerous health providers throughout Orange County apply the most advanced medical knowledge - for neurological disorders, digestive diseases, women's health and more - ensuring that our community and its residents become healthier and stronger.

This union of discovery, teaching and healing has enabled UCI Health to pioneer new therapies and techniques that have been adopted by institutions across the nation. It gives us the expertise to diagnose and treat exceedingly rare conditions and diseases, always with the least invasive methods possible.

Most important, it means that you and your family have access to the highest quality, knowledge-driven care.

That is the UCI Health commitment: to bring personalized, leading-edge care to you and our community, to be the best place to give and get care.