The Executive Director, Patient Financial Services (PFS) is responsible for the medical center's Revenue Cycle Management. Implements initiatives to build compliant systematic approaches to maximizing revenue and cash flow. Directs all aspects of departmental responsibilities for all patient related business activities including patient billing, insurance billing, governmental program billing, commercial/managed care billing, special billing, payment application, collections and patient advocacy. Negotiates beneficial contracts with various payors and insurers. Maintains current knowledge on billing practices and ensures billing systems meet requirements from insurers and government/state programs such as Medicare and Medicaid.
Primary Duties and Responsibilities:
Oversees the process to resolve operational issues within the revenue cycle.
Develops comprehensive, progression programs that enhances our patients satisfaction, physician satisfaction, increase our data capture quality while increasing our operational performance.
Participates in payer meetings to reduce insurance aging and ensure contractual obligations are being met.
Directs and evaluates departmental operations, including information technologies, service level determination, and complaint management, to achieve performance and quality control objectives.
Directs operation of third-party billing and responsible for development of policies and procedures that ensure the appropriate maintenance of PFS commercial, governmental, managed care, and special billing and accounts receivable systems.
Reviews and evaluates on a regular basis, the effectiveness of third-party billing, tracing and follow-up activities; oversees development and maintenance of good working relationship with third parties and government agencies receiving claims from CSMC.
Directs operation of revenue collection; develops policies and procedures that ensure appropriate effectiveness of collection of accounts receivable; oversees development and evaluation of outsourced and collection agency relationship with CSMC.
Providing healthcare for more than 100 years, Cedars-Sinai has evolved into one of the most dynamic and highly renowned medical centers in the world. Along with caring for patients, Cedars-Sinai is a hub for biomedical research and a training center for future physicians and other healthcare professionals. This attracts exceptional talent to Cedars-Sinai, including world-renowned physician-scientists who seek a place where they can both conduct research and see patients--the ideal formula for discovery and its translation into cures. Our patients benefit from access to doctors at the top of their fields, and our researchers have an ideal community in which to study the impact of healthcare challenges, and reflect that knowledge in their research. The greater Los Angeles area in which Cedars-Sinai resides possesses unparalleled cultural and ethnic diversity which offers outstanding opportunities for translational and clinical research and a dynamic environment for medical education.Although community based, Cedars-Sinai is a major t...eaching hospital affiliated with the David Geffen School of Medicine at the University of California, Los Angeles (UCLA). Cedars-Sinai has highly competitive graduate medical education programs in more than 50 specialty and subspecialty areas, a graduate program in biomedical sciences and translational medicine, a clinical scholars program directed towards junior physicians with aspirations to become clinical scientists, and post graduate training opportunities.There are more than 250 full-time faculty members at Cedars-Sinai. The voluntary medical staff, comprised of more than 2,200 specialty board-certified or board-qualified physicians, represent all of the specialties and subspecialties and collaborate with full-time medical staff in the teaching responsibilities of the graduate medical education programs.