Director of Patient Business Services – Revenue Integrity

Job title: Director of Patient Business Services – Revenue Integrity

Company: County of Santa Clara

Job description: DescriptionUnder general direction, to plan, direct and coordinate the functions and staff of Patient Business Services (PBS) within the Santa Clara Valley Health and Hospital System (SCVHHS) and to assist in developing patient billing and revenue collection policies.The current vacancy in Revenue Integrity Unit is responsible for ensuring the timeliness, accuracy, completeness and compliance related to charge capture. The Director for this unit will support clinical departments in the clinical capture and triggering of charges for patient services provided; and the resolution of any charging pending due to provider delays or errors (e.g., charges landing in Charge Router or Charge Review work queues). In addition, the Director will ensure all services provided at 4 Acute hospitals, Sub Acute unit and health care centers for outpatient and inpatient services are built and maintained within the HealthLink Charge Description Master for both Hospital and Professional services. This includes ensuring charges exist and are active (or inactive) with the HCPCS/CPT codes, Revenue Code, and Pricing. The Director will partner with Billing teams to assure CDM output aligns with payor billing requirements as well as organizational pricing strategies, which will also assist in achieving maximum reimbursement for the health system. Assuring compliance with regulatory standards and organizational goals.
The eligible list may be used for other positions within PBS Department.Typical Tasks

• Guides and directs subordinate staff on the functions of Patient Business Services;

• Selects, hires, evaluates and ensures the orientation, training and development of staff;

• Directs and monitors the day to day functions of all areas of Patient Business Services; ensures and maintains effective patient billing revenue collections;

• Provides key leadership in ensuring Valley Medical Center’s success in meeting its Mission and Values commitment;

• Plans, organizes, directs, and evaluates subordinate management staff;

• Develops, implements and monitors operational policies and procedures;

• Directs operational Continuous Quality Improvement Program within Patient Business Services;

• Directs Patient Business Services Compliance Program;

• Identifies, analyzes, interprets and monitors regulatory requirements and trends which may have financial or operational impact; recommends, develops, directs and/or implements necessary actions;

• Collaborates with technical staff to assess, design, create, modify and troubleshoot information systems to develop, support, enhance and maintain the operations, processes and performance of patient accounting and associated operations;

• Directs and monitors compliance with all applicable regulatory requirements;

• Prepares annual department goals and objectives in collaboration with subordinates;

• Develops and provides reports regarding account receivables and Patient Business Services performance;

• Prepares, oversees and monitors the patient business services budget and performance;

• Assists patients, physicians and department personnel in resolving billing and/or collections problems;

• Represents the department in internal and external meetings on matters involving Patient Business Services;

• Acts in the absence of the Revenue Cycle Director;

• May be assigned as a Disaster Service Worker, as required;

• Performs other related duties as required.

Employment StandardsSufficient education, training and experience to demonstrate possession of the following knowledge and abilities:Training and Experience Note: The knowledge and abilities required to perform this function are acquired through training and experience equivalent to a Bachelor’s Degree in Health Care Administration, Accounting, Business Administration, or a related field and five (5) years professional level experience in managing a health care related patient accounting office.Certification:Must obtain appropriate Epic certification within six (6) months of appointment or vacate the position.Knowledge of:

• Operations of a patient business services for a large complex health care facility; including clinic, hospital, ancillary and professional fee billing and collection;

• Special County or Federal Programs;

• Patient accounting information systems;

• Cash processing and general accounting practices;

• Diagnostic and procedure coding;

• Charge Entry;

• Principles and practices of organization, administration and personnel management, including selection, supervision, discipline, training and staff development;

• Healthcare laws and regulations and requirements for third party billing (Medicare and Medi-Cal);

• Principles and practices of budgetary preparation and control;

• Office management principles, methods and procedures;

• Principles of patient relations and customer service;

• Human resource principles and practices, including labor organizations, labor laws, etc.;

• Principles and practices of change management;

• Project management;

• Principles and practices of continuous quality improvement;

• Compliance issues as they relate to the billing and collections of facility and professional fees.

Ability to:

• Manage, train, develop and motivate subordinate staff;

• Direct, administer, coordinate and supervise the patient business services functions of a large health and hospital system, including but not limited to the billing and collections of facility and professional services;

• Identify problems which negatively impact the efficient operations of Patient Business Services and develop and implement procedural changes and/or recommendations;

• Understand, apply and implement applicable hospital policies, regulations and administrative procedures;

• Direct, coordinate and/or motivate the activities of groups, including groups that may not have a direct reporting relationship;

• Quickly and accurately access and resolve complex issues;

• Give presentations to large groups;

• Keep informed of, analyze, interpret, and implement State and Federal regulations;

• Manage difficult and sensitive policy issues; and management problems;

• Be self directed and make sound independent decisions;

• Work cooperatively and effectively as a member of a management team;

• Establish and maintain cooperative working relationships;

• Communicate effectively both verbally and in writing;

• Write clear and concise correspondence and reports.

The County offers comprehensive first-class medical, dental, and vision benefits plans for County employees and their dependents, including plans with no deductibles, no co-pays, no co-insurance, and no prescription drug co-pays. Learn more .The County also offers generous paid time off with significant vacation, sick time, and 13 paid County holidays annually! Details are included in the with the bargaining unit applicable to the job classification.In addition to the amazing perks above, the County also offers the additional benefits below.Retirement Benefits
The County offers robust retirement plans including a (similar to the private sector’s 401(k) plan) and the . In addition to lifetime retirement income available through the CalPERS pension plan, the 457(b) Deferred Compensation plan provides a great way to save for retirement and supplement the defined benefit pension available to employees. These plans help our employees build a plan for their future and contribute to their family’s long-term financial well-being.Health Flexible Spending Account
The empowers employees to manage healthcare expenses efficiently with tax-free contributions (up to $3,200 for the 2024 calendar year). Secure tax-free solutions for your healthcare expenses and enjoy the flexibility to manage your healthcare finances effectively with the HFSA.Dependent Care Assistance Program (DCAP)
The enables employees to utilize tax-free funds for dependent care services, facilitating a convenient and cost-effective approach for managing your dependent care expenses. The County also offers the , an employer-funded DCAP, for employees with annual income under $120,000.Life and AD&D
The County offers life and disability benefits including , Insurance, . These benefits ensure financial security and income support when you and your family need it most.Employee Assistance Program (EAP)
The County prioritizes employee mental health and well-being and offers a top-tier through Concern providing confidential counseling sessions covering stress, anxiety, relationships, grief, as well as financial/legal services, personal coaching, child and elder care referrals, and comprehensive crisis support.Employee Wellness
The offers free wellness programing, fitness classes and resources; including Elevate My Wellness an all-in-one platform designed to elevate your well-being journey.Education Reimbursement
A generous program is available, including Education Reimbursement for employees seeking additional training and professional development.NOTE: Benefit and Retirement information may vary from bargaining unit to bargaining unit. Due to changes in State Law, current pension provisions described in the union contracts are not automatically applied. Specific pension benefits for new hires who start on or after January 1, 2013 may be different than indicated in the union contracts.

Expected salary: $163662.72 – 198956.16 per year

Location: Santa Clara, CA

Job date: Thu, 29 May 2025 23:57:17 GMT

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