Director, PFS Home Care & Audit

Department Name:

PFS HME & HIT

Work Shift:

Day

Job Category:

Revenue Cycle

Estimated Pay Range:

$50.12 - $83.54 / hour Banner Health is committed to pay equity and transparency. The posted compensation range is a reasonable estimate that extends from the lowest to the highest pay Banner Health in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. This range is based on possible base salaries and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.

Help lead health care into the future. As one of the largest nonprofit health systems in the country, Banner Health has both the stability that comes with success and the values you can be proud to represent. If you’re looking to leverage your abilities – you belong at Banner Health.

Banner Home Health is a four-star home care agency with a track record for quality and excellence and is the largest skilled home care agency in Phoenix. We provide support to our therapy teams with a robust clinical support team: a field preceptor, an IT specialist, scheduler, therapy supervisor, and nurse manager. Our agency strives for the best possible patient outcomes with support from QI specialists, documentation support specialists, telehealth resources, and more. Having a strong clinical support structure is important to supporting our field clinicians in managing their caseload appropriately while not feeling alone.

The Director of Patient Financial Services (PFS), Home Care & Audit will provide strategic leadership for revenue cycle operations specifically tailored to home health settings, ensuring accurate reimbursement through auditing and compliance. In this role you will lead internal and external audits, create and implement SOP's and provide operational oversight in revenue cycle management for home health services.

Ideal Candidate

• Bachelor's degree in healthcare administration, Business or Finance.
• 5-8yrs experience in healthcare Revenue Cycle management, with an emphasis in home health regulations.
• Proficiency in HCHB (Homecare Homebase), TIMs, CPR Plus and Brightree
• Must have strong system optimization and leadership experience (clearly reflected on your attached resume)

Your pay and benefits are important components of your journey at Banner Health. This opportunity includes the option to participate in a variety of health, financial, and security benefits. In addition, this position may be eligible for our Management Incentive Program as part of your Total Rewards package.

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.

POSITION SUMMARY
This position directs the patient financial services and accounts receivable work for Home Care services, home medical equipment, home infusion therapy, pharmacy and related services lines. Through the effective development of operational procedures and staff, leadership and operational management, provides effective patient financial counseling services, timely and accurate billing, collections that meet established goals, and accurate posting and reconciliation of payments for all entities for Home Care divisions, Retail and Specialty Pharmacies.

CORE FUNCTIONS
1. Leads, develops and maintains a competent and engaged staff through effective hiring, training, coaching, and empowerment. Directs and oversees personnel actions including recruiting, new hire actions, interviewing and selection of new staff, staff reviews, and salary determinations for the patient financial services and management and staff in the Home Care and Pharmacy PFS.

2. Establishes and oversees the development and implementation of processes and procedures to assure that billing and collections work meets the most current requirements of Medicare, all insurance company payers and each state’s Medicaid plan. Establishes short and long-range goals, strategies and objectives for the work units. Develops and implement programs to increase efficiency and effectiveness of the Pharmacy PFS functions and the Home Care Central Back Office.

3. Maximizes cash flow through effective management of billing and collections work, developing effective relations with third party payers, preparing and executing strategic and financial plans, and ensuring that all goals are met. Negotiates settlements of disputed accounts and reimbursement denials.

4. Maintains a cost-efficient operation. Plans and prepares an appropriate budget for assigned cost centers. Provides expense control and effective management in the allocation of resources.

5. Collects and analyses data and performance statistics for assigned business units. Communicates business results, needs and recommendations to operating groups and to management. Works with operating managers and service providers to maximize results of patient accounting work.

6. Through the planning and execution of effective customer service and business strategies and practices, maintains a low level of patient complaints and high level of patient satisfaction. Develops a well-trained staff that maintains a high level of quality, good business practices, and effective problem resolution.

7. This position manages the payment posting and reconciliation of receivables of greater than $150M annually and manages an expense budget of $1.7M. Must have extensive knowledge of Medicare, Medicaid in several States, and contractual arrangements with multiple payers. Responsible for leading assigned operational planning, consistent with company priorities, to identify and reach short and long term goals. Internal customers include but are not limited to employees, other directors and administrators at the local, regional, and corporate level. External customers include but are not limited to patients, physicians, insurance payers and vendors. This position manages Accounts Receivable functions for System Home Care functions for multiple States. This position also works with all Hospital facilities related to the charging process and needs to have a strong knowledge basis of charging procedures and Compliance requirements.

MINIMUM QUALIFICATIONS

Requires a Bachelor’s Degree with an emphasis in Finance or Accounting or equivalent experience.

A minimum of five years of healthcare financial management experience with at least two years in a hospital setting, along with experience in a broad range of billing and patient account audit practices.

Requires strong negotiating, analytical and organizational skills as well as the ability to be flexible with changing needs and deadlines; the ability to interact and communicate both verbally and in writing with all levels of company personnel and outside professionals is a must. Must have a solid understanding of the healthcare revenue cycle, payer contracts and applicable rules and regulations affecting reimbursement for healthcare services.

PREFERRED QUALIFICATIONS

Additional related education and/or experience preferred.

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