JOB SUMMARY:
The Patient Financial Services Director serves as the strategic and operational leader responsible for overseeing, optimizing, and continuously improving middle and back end revenue cycle across Beaufort Memorial's acute and outpatient settings. This leader will drive operational excellence through innovation, compliance, data analytics, and workforce engagement, ensuring that revenue cycle operations support both financial health and patient satisfaction.
The role requires a visionary leader with a deep understanding of healthcare finance, reimbursement models, payer relations, and technology transformation. This individual will champion initiatives that enhance accuracy, transparency, and efficiency throughout the patient financial journey, from pre-access to final account resolution.
Key Responsibilities
Strategic Leadership & Vision
- Develop, communicate, and execute a comprehensive revenue cycle strategy aligned with Beaufort Memorial's mission, growth goals, and financial performance targets.
- Serve as a key member of the finance leadership team, providing insights to the CFO, CEO, and executive team on revenue trends, payer performance, and strategic opportunities.
- Lead enterprise-wide revenue cycle initiatives, including automation, digital payment platforms, and system modernization (Meditech, EHR/billing upgrades, AI-assisted workflows, price transparency).
- Build governance structures and performance dashboards to ensure accountability and continuous improvement.
Operational Excellence
- Oversee all functional areas of the revenue cycle, including Billing, Coding, Denials Management, and Collections.
- Implement and monitor key performance indicators (KPIs) such as cash collections, DNFB, AR days, denial rates, cost-to-collect, and first-pass resolution rates.
- Leverage data analytics and automation (RPA, AI, predictive analytics) to streamline workflows, reduce rework, and improve accuracy.
- Lead denial prevention and appeal strategies, utilizing root-cause analysis and performance metrics to drive resolution.
- Engage proactively with payers to address chronic underpayments, identify trends, and negotiate improved operational performance.
Compliance, Risk & Regulatory Alignment
- Ensure adherence to all federal, state, and payer regulations (CMS, HIPAA, No Surprises Act, Price Transparency).
- Oversee audit readiness and risk mitigation programs, maintaining robust internal controls and monitoring for compliance gaps.
- Partner with the Compliance Department to develop corrective action plans and lead staff education related to revenue cycle policies and procedures.
Patient Financial Experience
- Champion a patient-centered billing experience, ensuring clear communication, price transparency, and compassionate collection practices.
- Oversee financial counseling and cost estimate programs, supporting patients in understanding and managing their financial responsibilities.
- Introduce and manage digital payment options, mobile billing platforms, and self-service tools to improve convenience and satisfaction.
Technology & Innovation
- Lead technology modernization efforts within the revenue cycle, integrating automation, AI tools, and predictive analytics to drive efficiency.
- Partner with IT and Finance on system integrations, EHR optimizations, and vendor solutions for claims processing, early-out services, and eligibility verification.
- Champion digital transformation initiatives that reduce administrative burden and enhance staff and patient experience.
Talent Development & Leadership
- Build and mentor a high-performing revenue cycle team, fostering professional development, succession planning, and cross-training.
- Create a culture of collaboration, accountability, and inclusion, ensuring staff are engaged and aligned with organizational values.
- Facilitate regular leadership development, process improvement workshops, and best-practice sharing across departments.
Collaboration & Partnership
- Collaborate cross-functionally with Finance, Clinical Operations, Case Management, IT, and Compliance to ensure accurate clinical documentation and reimbursement alignment.
- Maintain relationships with external vendors (e.g., clearinghouses, early-out, bad debt, and coverage discovery partners), ensuring quality, compliance, and contract performance.