NH PFS Manager - Hospital Authority of Miller County : Job Details

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The Patient Financial Services Manager will also be responsible for all HAMC activities in accordance with current applicable federal, state, and local standards, guidelines, and regulations and is directed by the CFO, to ensure the proper administrative procedures are always maintained. The Patient Financial Services (PFS) Manager is also responsible for managing all non-clinical financial operations related to post-acute and ancillary care services.

EDUCATION, CREDENTIALS & EXPERIENCE REQUIREMENTS:

• A Bachelor's degree in Healthcare Administration, Finance, Accounting, or a related field required.
• At least 2 years in a leadership or supervisory role.
• Working knowledge ranging from beginner to proficient level is acceptable, with a willingness to learn and grow in the role of Medicare, Medicaid, and commercial billing for SNF, Home Health, ALF, Adult Day Care, Pharmacy, Infusion, and Transportation services.
• Proficient in healthcare billing software and EHR systems; strong Excel and analytical skills.
• Excellent communication, organizational, and leadership abilities.
• Experience with systems such as MatrixCare, Brightree, or ModivCare billing will be helpful
• Working knowledge of PDPM, OASIS, HHA billing standards, and NCPDP for pharmacy billing will be helpful.
• Familiarity with non-emergency transportation billing under Medicaid and managed care plans.
• Preferred CAH and RHC experience.
• Experience with the Federal, State and other healthcare payors in needed

JOB SPECIFIC COMPETENCIES:

• Keeps current on the latest business and technical developments through continuing education and educating staff accordingly.
• Conducts employee performance appraisals according to HAMC guidelines.
• Updates procedure manuals and job descriptions as operations and requirements change.
• Demonstrates effective and proper oral and written communications.
• Accepts special assignments from upper management and completes projects on time.
• Selects and monitors outside collection vendors engaged in the collection of hospital receivables. Reviews and balances agency reports and approves agency invoices.
• Ability to interpret an extensive variety of concepts such as billing/collection regulations and requirements.
• Knowledge of medical terminology, ICD10 and CPT procedure coding
• Ability to effectively and appropriately communicate ensuring exceptional customer service.
• Computer experience – Microsoft Word and Excel proficient
• Ability to perform multiple tasks, strong verbal and written skills and sound decision-making abilities.
• Knowledge of HIPAA compliance requirements.

REVENUE CYCLE OVERSIGHT:

• Direct and manage the full revenue cycle process from charge entry through payment posting and collections for all designated service lines.
• Ensure prompt and accurate claim submissions and resolution of claim denials or rejections.
• Oversee billing operations for Medicare, Medicaid, commercial insurance, and private pay across all services including:

1)Skilled Nursing Facilities (SNF)

2)Home Health Services

3)Assisted Living Facilities (ALF)

4)Adult Day Care

5)Pharmacy Infusion Therapy

6)Transportation Services (non-emergency, medical)

• Ensure compliance with federal and state regulations, including HIPAA and payer-specific billing requirements.

ACCOUNTS RECEIVABLE & REPORTING:

• Monitor and analyze accounts receivable trends and performance metrics.
• Lead monthly A/R reviews and ensure targets such as days in A/R and collection percentages are met.
• Prepare regular reports for leadership on financial performance, denials, and collection efforts.

TEAM LEADERSHIP

• Supervise billing and collection staff across assigned service lines.
• Provide training, performance evaluations, and support to promote a culture of accuracy, accountability, and efficiency.

SYSTEM & WORKFLOW OPTIMIZATION:

• Collaborate with IT and EHR teams to optimize billing system functionality and integration.
• Implement process improvements to enhance cash flow, streamline workflows, and reduce billing errors or delays.

COLLABORATION & SUPPORT:

• Serve as a liaison between finance, admissions, registration, and external vendors as needed.
• Assist with payer audits and ensure documentation and billing practices support regulatory and contractual requirements.

Seniority level

• Seniority levelMid-Senior level

Employment type

• Employment typeFull-time
• IndustriesHospitals and Health Care

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