Summary: Under the direction of the BSWH Vice President of Patient Financial Services, the System Director, Hospital Billing & Collections provides the strategic direction and oversight for the billing, third-party collections, and underpayment functions for all BSWH wholly owned and managed joint venture hospitals.
Monitor and report on key metrics, including but not limited to: cash collections, net A/R days, agings, DNFB, initial denial rates, underpayments, clean claims %, administrative write offs, payment-to-charge percentage (PCR), and cost-to-collect. Proactively perform root cause analyses and develop action plans when metrics do not meet internal goals or industry best practices. Complete monthly trending analyses and present findings at monthly operational review meetings to senior revenue cycle leadership.
Prepare executive level presentations to inform senior revenue cycle and finance leadership about trends and issues impacting performance. Summarize detailed data in a clear and concise manner so that information is actionable and in an easy-to-understand format.
Prepare analyses and information with senior revenue cycle leaders and entity/regional Chief Financial Officers prior to financial close meetings related to revenue cycle performance and impact on net revenue.
Maintain deep understanding of key processes within the department and constantly evaluate opportunities for improvement. Ensure standardization of processes across all locations, regardless of patient accounting system. Monitor and report overall status of key projects and initiatives at revenue cycle strategy meetings.
Develop and monitor adherence to specific goals, performance standards, and policies & procedures for each area of responsibility. Define, implement, and manage clear quality and productivity standards across all areas of responsibility.
Provide guidance for billing and collection management to resolve internal and external issues. Routinely conduct payer trend analysis, focusing on initial denials and underpayments, to ensure optimal claims processing and reimbursement. Coordinate with the Office of Managed Care and the legal and compliance departments to address payer issues that affect hospital billing and collections.
Stay abreast of third-party payer and governmental regulations and requirements as well as company policies and procedures to ensure billing compliance and timeliness of collections. Proactively implement operational changes and provide timely staff education to maintain adherence. Collaborate with legal and compliance departments on matters that impact hospital billing and collections.
Maintain detailed understanding of multiple patient accounting systems, including system functionality, workflows, and reporting. Proactively identify areas for improvement and engage with Information Services and vendors to make necessary changes. Develop innovative approaches for solving problems with system automation and functionality. Lead internal subcommittee to vet new enhancement and project requests through the Information Services governance process.
Assume a lead role for innovation, knowledge sharing and leading practice identification within hospital billing and collections. Identify and assess new technology and process improvements that reduce cost-to-collect. Perform ROI analysis and provide recommendations to senior revenue cycle leadership.
Monitor the local and national emerging and best practices associated with hospital billing and collections. Constantly review and evaluate the effectiveness and efficiency of operations and develop and lead operational modifications as conditions change. Lead the implementation of best practice strategies to increase cash flow and turnaround time in account resolution.
Develop detailed actions plans for integrating new service lines and/or new facilities. Capitalize on opportunities for improvement quickly, ensuring performance standards are met or exceeded within established timeframes.
Investigate and resolve complex problems and coordinate efforts to provide innovative strategies and solutions.
Maintain departmental budget and perform all human resource functions. Develop and implement strategies to improve employee engagement. Actively participate in succession planning and developing career advancement opportunities for employees within department.
Demonstrate ability to adapt to and lead change and to coach others in the acceptance and support of change.
Obtain buy-in from senior revenue cycle leadership on strategic direction of hospital billing & collections department. Communicate BSWH's ambition and strategies, translating them into actionable projects and initiatives for management and staff.
Perform other position appropriate duties as required in a competent, professional, and courteous manner.
Strong written and verbal communication skills
Ability to manage demanding workload and to demonstrate resiliency during stressful or high-stake situations
Ability to build strong interpersonal skills with all levels of employees - including executives and front line staff
Strong understanding of revenue cycle processes and technology
Strong organizational and analytical skills
Ability to be flexible and adapt to changing priorities and initiatives
Strong attention to detail, but ability to summarize information in a clear, concise manner
Strong Microsoft Excel and PowerPoint skills
Knowledge of third party (government and non-government) billing regulations and various payer methodologies
Ability to research and interpret regulatory guidance and third party payer contracts
Bachelor's degree required 7 plus years related experience required
Internal Number: 19000631
About Baylor Scott & White Health
Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!