Director - Professional Billing Organization (Remote)

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This is a Stanford Health Care job.

A Brief Overview
The Director, Professional Billing Organization (PBO) manages all administrative and clinical functions that contribute to the capture, management and collection of patient service revenue generated by School of Medicine faculty and Stanford Medicine Partners physicians. The Director, PBO is responsible for enhancing and maintaining cash flow, revenue cycle performance, regulatory and HIPAA compliance, and guest relations.

Locations
Stanford Health Care

What you will do

• Assesses and responds to organizational and customers' needs with innovative programs to ensure customer satisfaction. Implements patient friendly billing guidelines.

• Completes/contributes to the completion of various financial forecasts, including cost center salary and direct expenses, month-end financial reporting, receivables levels, net matched collections, Days in Accounts Receivable and aging, reserve analysis, cost center productivity, benchmarking, and any long-range strategic plans for the department.

• Directs ongoing programs for staff development and training that fosters and mentors the next generation of Revenue Cycle leaders.

• Ensures compliance with relevant regulations, standards and directives from regulatory agencies and third- party payers.

• Maintains and fosters excellent payer relations with key fiscal intermediaries and government oversight agencies such as CMS, Medi-Cal, DHS, etc. Maintains and fosters excellent relationships with contracted health plans and medical groups to support effective claims submission/resolution and contract compliance. Maintains a climate of confidence in the billing process and results, with Department Chairs, physician leadership, and DFAs.

• Maintains appropriate internal control safeguards over AR records, write-offs and collection of cash. Maintains compliance standards for providing accurate information on all facility or health system billings.

• Manages all service programs, including external vendor programs and systems.

• Manages, prepares and presents capital and operating budgets that demonstrate prudent use of organization's resources while at the same time achieves and maintains organizations goals and key performance indicators.

• Monitors and support daily staff functions. Participates in key Revenue Cycle stakeholder venues such as physician and clinic leadership venues, IT, Contracting, and Department of Finance Administrators (DFAs) Oversees the financial interface between and performance analysis of the patient financial services functions and fiscal services functions. Oversees the integrity of financial and clinical interfaces, while facilitating the development of strategic system planning.

• Performs related duties such as selecting and evaluating the performance of key reporting staff; preparing various reports, correspondence and position papers; conducting and/or attending meetings and conferences and serving as the department's primary appointing authority.

• Plans, coordinates and prepares year-end audits with public accounting firms and third-party auditors as they relate to AR operations. Mediates and resolve conflicts regarding public accounting firms, third-party auditors and investigate parties.

Education Qualifications

• Bachelor's degree in a work-related field/discipline from an accredited college or university.

• Master Degree preferred

Experience Qualifications

• Ten (10) years of progressively responsible and directly related work experience in patient billing management.

Required Knowledge, Skills and Abilities

• Ability to anticipate healthcare trends and alter the financial direction of the organization as necessary Ability to assess and keep current and compliant with all charity care, free bed fund and uninsured policies Ability to communicate complex concepts in simple form to non- finance users to understand the appropriate use and limits of the information provided.

• Ability to develop financial budgets and manage expenses.

• Ability to effectively influence change and manage effective the change process.

• Ability to evaluate appropriate and key partnerships such as outsourcing, collections, underpayment vendors, eligibility, etc.

• Ability to foster effective working relationships and build consensus.

• Ability to keep operations technology up to date both in terms of legacy systems, EDI capable as well as added value tie in technologies.

• Ability to provide leadership and influence others.

• Knowledge of all functional areas of the revenue cycle, including health information management, case management, and charge capture.

• Knowledge of computer systems and software used in functional area.

• Knowledge of financial statements and the impact of the revenue cycle on them, including aging reports, bad- debt analysis, and calculation of bad-debt allowance.

• Knowledge of local, state and federal regulatory requirement related to the functional area.

• Knowledge of patient registration, billing, A/R, cash-management requirements, managed care contractual terms and requirements, health insurance practices, industry regulatory requirements (compliance and HIPAA), business office operations, A/R and financial reporting technology, wage and hour regulations, basic accounting and industry standard for healthcare revenue resolution management practices.

• Knowledge of principles and practices of organization, administration, fiscal and personnel management.

Licenses and Certifications

• None

These principles apply to ALL employees:

SHC Commitment to Providing an Exceptional Patient & Family Experience

Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.

You will do this by executing against our three experience pillars, from the patient and family’s perspective:

• Know Me: Anticipate my needs and status to deliver effective care

• Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health

• Coordinate for Me: Own the complexity of my care through coordination

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.