VP, Patient Financial Services

Job Description

Job Description

Job Overview

The role involves providing strategic leadership and operational management for Patient Financial Services (PFS) encompassing both hospital and physician billing. The individual will define and communicate the strategic vision, working closely with peer leaders and the Senior Vice President of Revenue Cycle to establish plans and key performance indicators (KPIs). Responsibilities include monitoring performance metrics, market dynamics, and regulatory developments. The position also entails overseeing claim submissions, accounts receivable (A/R) follow-up, cash and adjustment postings, denial management, and patient collections to enhance A/R days, collection rates, and denial rates. Collaboration with clinical and executive leaders is essential, utilizing analytics to foster process improvements and implement initiatives aimed at maximizing net revenue.

• Define and communicate the strategic vision for PFS, ensuring alignment across Hospital and Physician Billing teams.
• Work in partnership with Revenue Cycle leadership to create strategic plans and KPIs for the organization.
• Track performance metrics, market trends, delivery systems, and legislative changes that may affect objectives.
• Enhance talent utilization and cultivate a culture that aligns with the organization's mission through effective leadership and development.
• Provide financial planning, oversight, and execution to ensure a cost-efficient PFS organization.
• Monitor clean claim rate performance to minimize unbilled A/R days.
• Ensure effective follow-up on claims to secure timely and complete payments from payers and patients.
• Authorize and supervise the posting of insurance cash and adjustments to ensure accurate and timely payment processing.
• Analyze both qualitative and quantitative metrics to promote continuous improvement initiatives.
• Oversee the performance and throughput of onshore and offshore vendor resources, collaborating on service level agreements (SLAs) and invoicing.
• Manage overall A/R trends by facility, payer, and other relevant factors, coordinating with Managed Care for resolution.
• Engage with stakeholders to enhance personnel, processes, and technology within billing operations.

A Bachelor's degree is required; a Master's degree is preferred.

At least 15 years of proven senior leadership experience in a large, complex multi-site health system's Revenue Cycle or PFS function.

• Ability to make data-driven decisions, conduct cost/benefit analyses, and build consensus among stakeholders.
• Strong communication, relationship management, customer service, organizational, and change leadership skills.
• Understanding of provider operations and patient flow to identify revenue cycle cause-and-effect issues; familiarity with A/R management and accounting principles.
• Comprehensive knowledge of payer payment methodologies, contracts, regulations (including Medicare/Medicaid), coding (ICD, HCPCS/CPT), and physician billing.
• Proven experience in leading large-scale operational transformation initiatives that enhance efficiency, quality, and financial results.
• Demonstrated ability to design and implement strategies that yield measurable improvements in patient financial services performance.
• Advanced problem-solving skills, including the capacity to diagnose complex operational challenges and implement sustainable solutions.
• Ability to innovate within existing operational frameworks, introducing new models, technologies, and workflows to modernize PFS operations.
• Strong strategic thinking skills with the capability to translate organizational priorities into actionable plans for PFS functions.

• Experience in overseeing third-party vendors (both onshore and offshore) and managing service level agreements (SLAs).
• Familiarity with enterprise revenue cycle systems, dashboards, KPI management, and denial analytics.