VP, Patient Financial Services
Responsible for strategic leadership and operational oversight of Patient Financial Services (PFS) across hospital and physician billing. Identifies and articulates strategic direction; collaborates with peer leadership and the SVP of Revenue Cycle to define the plan and KPIs; tracks performance, market trends, and regulatory changes. Oversees claim submission, A/R follow-up, cash and adjustment posting, denial management, and patient collections to optimize A/R days, collection rates, and denial rates. Partners with clinical and executive leaders, leverages analytics to drive process improvement, and implements initiatives to maximize net revenue.
Duties and Responsibilities
* Identify and communicate strategic direction for PFS; align teams across Hospital and Physician Billing.
* Collaborate with Revenue Cycle leadership to design strategic plans and KPIs for the organization.
* Monitor performance, market trends, delivery systems, and legislative initiatives impacting goals.
* Maximize talent and foster a culture aligned to the BILH mission through leadership and development.
* Provide financial planning, monitoring, and execution to support a cost-effective PFS organization.
* Oversee clean claim rate performance to reduce unbilled A/R days.
* Ensure effective claim follow-up to support timely, complete expected payment from payers and patients.
* Approve and oversee insurance cash and adjustment posting for timely, accurate payment posting.
* Analyze qualitative and quantitative metrics to drive continuous improvement initiatives.
* Oversee throughput and performance of onshore/offshore vendor resources; collaborate on SLAs and invoicing.
* Manage overall A/R trends by facility, payer, and other dimensions; coordinate with Managed Care for resolution.
* Collaborate with stakeholders to improve people, process, and technology across billing operations.
Qualifications
Education / Training
Bachelor's degree required; Master's degree preferred.
Experience
15+ years' demonstrated senior leadership in a large, complex multi-site health system Revenue Cycle or PFS function.
Skills, Knowledge & Abilities
* Data-driven decision-making; ability to conduct cost/benefit analyses and drive consensus among stakeholders.
* Excellent communication, relationship management, customer service, organizational and change leadership skills.
* Knowledge of provider operations and patient flow to diagnose revenue cycle cause-and-effect issues; understanding of A/R management and accounting principles.
* In-depth knowledge of payer payment methodologies, contracts, regulations (Medicare/Medicaid), coding (ICD, HCPCS/CPT), and physician billing.
* Demonstrated experience leading large-scale operational transformation initiatives that improve efficiency, quality, and financial outcomes.
* Proven ability to design and execute strategies that drive measurable improvements in patient financial services performance.
* High-level problem-solving skills, including ability to diagnose complex operational issues and implement sustainable solutions.
* Ability to innovate within legacy operational environments, introducing new models, technologies, and workflows that modernize PFS operations.
* Strong strategic thinking capabilities with ability to translate enterprise priorities into actionable plans for PFS functions.
Preferred Qualifications
* Experience overseeing third-party vendors (onshore/offshore) and managing SLAs.
* Proficiency with enterprise revenue cycle systems, dashboards, KPI management, and denial analytics.
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