Reporting to SSM's System Vice President Revenue Management, this position is responsible for providing leadership and overseeing key operational and financial decisions pertaining to the management of System-wide patient financial service operations. The position is responsible for developing and managing functions of Scheduling, Pre-registration, Insurance Authorization, Verification of insurance benefits, Collections of patient payment obligations and vendor performance management. The leader will bring state-of-the-art technology and industry leading processes to co-ordinate these functions to deliver an exceptional patient experience and significantly lower costs of operations. The position is also responsible for developing and operating web, e-mail and phone systems to keep patients informed of our financial policies, to respond to patient billing inquiries and to manage the patient service recovery process. The position also develops and manages SSM Financial Support policy working with SVP Mission, Legal & Government Affairs.
The incumbent serves as the Patient Financial Operations leader for the system to internal and external organizations, including government agencies, payer organizations, external auditors, and business partners for patient collections. The incumbent is expected to provide guidance to staff for maintaining compassion and respect to patients and standards for upholding efficient and effective processes and operations.
Responsible for reducing bad debt and increasing patient cash collections year over year.
Responsible for meeting or exceeding all metrics relative to Pre-Service Collections, Point of Service and Post Service Collections.
Responsible for meeting or exceeding all metrics relative to converting self-pay patients to Medicaid or other alternative coverage's
Directs the Patient Financial Services team that provides support in all areas of Patient Business Services for those duties
Ensures Patient Financial Services staff across all PBS functions (pre-registration, financial clearance, self-pay accounts receivable, customer service) complies with established policies, processes, and quality assurance programs relative to patient collections.
Works with peers to coordinate and oversee all financial clearance, financial counseling, and self-pay accounts receivable process transition points between onsite patient access services and pre-service operations as well as collection agencies.
Develops, implements, and manages efficient and effective operational policies, processes and performance monitoring within financial clearance, self-pay accounts receivable, and customer service functions
Works with peers to coordinate and oversee all self-pay accounts receivable and customer service process transition points between onsite patient service center and CBO.
Works with various Patient Business Services stakeholders, state agencies, insurance companies, and third parties to ensure timely and appropriate resolution of acute care self-pay accounts receivable and eligibility services.
Coordinates and Facilitates the Self Pay Strategy cross function team to review and implement innovation as well as to monitor compliance to the SSM System charity care policy, as well as Government and Payer Contract mandates.
Measures and reports ongoing financial and operational performance of Patient Financial Services. Recognize areas of excellence and oversee the development and implementation of function-specific action plans within Patient Financial Service operations and other matrixes organizations for self pay collections where performance is not meeting expectations.
Identifies emerging IRS reporting and tax compliance issues relevant to patient collections, determines the potential effect on the system and develops recommendations regarding system response for the consideration of the Corporate Vice President - Finance and Treasury, and the Senior Vice President – Finance.
Identifies and recommends potential process improvements in areas of expertise, and assists with the design and in implementation as requested.
Provides system-wide information and prepares reports and statements required to meet Internal/external reporting requirements and requests.
Identifies potential improvements in system and work processes, and makes recommendations for improvement. Participates in CQI projects as a team leader or member, as required. Assists in the implementation of improvements.
Creates a work environment for staff through team building, coaching, constructive feedback, work delegation, personal example and goal setting that encourages creativity, open dialogue on work issues, professional growth, and a consistent, high level of performance. Encourages and supports staff decision-making within their scope of responsibilities.
Works with corporate and regional colleagues throughout SSM to continuously improve the Patient Business Services, while enhancing service to patients, and optimizing relationships with strategic business partners
Builds strong relationships and facilitate productive communication between key Patient Business Services stakeholders, including peer leaders of Patient Business Services and core support departments (e.g., human resources, integrated health technologies, finance).
Performs any special assignments as requested
Master's Degree in finance or accounting is required
A minimum of five years of increasingly responsible experience in health care finance, including a minimum of three years with direct experience with (Medicare and Medicaid) regulations is required
Health care consulting experience is a plus
SSM Health - System Office –
SSM Health is one of the largest Catholic health systems in the country and is dedicated to quality and compassionate care for anyone in need, regardless of ability to pay. Based in St. Louis, where its System Office is located, SSM Health operates 20 hospitals in Wisconsin, Illinois, Missouri and Oklahoma. We provide care in various settings: outpatient sites, physician offices, a pharmacy benefit company, an insurance plan, hospitals, nursing homes, home care, hospice, telehealth and a technology company.Our Mission: Through our exceptional health care services, we reveal the healing presence of God.
You’ve known us as many names throughout St. Louis, and now, we’re bringing our hospitals, doctors, home care and other services together under one name – SSM Health. With seven hospitals, 350+ physicians, more than 40 physician locations and 12,000 employees, we are part of something bigger and better. We’re connected to a wealth of resources, expertise and advance technology to help you, your fa...mily and our community live long, healthy lives.
We’ve grown and changed a lot over our 143-year history. Our name may be changing but our mission remains the same