VP, Patient Financial Services

Job Overview

We are seeking a strategic leader to provide operational oversight for Patient Financial Services (PFS) encompassing both hospital and physician billing. This role involves defining and communicating the strategic vision, collaborating with peer leaders and the Senior Vice President of Revenue Cycle to establish plans and key performance indicators (KPIs), and monitoring performance alongside market trends and regulatory developments. The position is responsible for managing 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. Additionally, this role will work closely with clinical and executive teams, utilizing analytics to foster process improvements and implement initiatives aimed at maximizing net revenue.

Key Responsibilities

• Define and communicate the strategic direction 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 organizational goals.
• Enhance talent utilization and cultivate a culture that aligns with our mission through effective leadership and development.
• Provide financial planning, oversight, and execution to maintain a cost-effective PFS organization.
• Monitor clean claim rates to minimize unbilled A/R days.
• Ensure efficient claim follow-up to secure timely and complete payments from both payers and patients.
• Authorize and supervise insurance cash and adjustment postings to guarantee 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 dimensions, coordinating with Managed Care for resolutions.
• Engage with stakeholders to enhance personnel, processes, and technology within billing operations.

QualificationsEducation and Training

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

Experience

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

Skills, Knowledge, and Abilities

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

Preferred Qualifications

• 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.