Assistant Director - Commercial - Patient Financial Services, UCI Health - F/T Days
Location: Orange, California, United States
Scheduled Work From Home Days: Hybrid schedule, work from home 2-3 days a week.
Position Summary:
As the Assistant Director of Commercial Patient Financial Services at UCI Health, this role is responsible for planning, directing, and managing all aspects of Accounts Receivables management within the Patient Financial Services department. This includes oversight of commercial, managed care, workers compensation, ERISA, self-funded, and other indemnity health plans. The incumbent ensures that unit operations comply with all state and federal healthcare regulatory agencies, actively participates in organizational performance improvement projects, and analyzes denial trends to enhance first-pass yield. This position holds overall responsibility for training, unit performance, resolution of operational and personnel issues, evaluations, hiring, and disciplinary action. The Assistant Director serves as a role model and resource, interacting with various levels within the organization, insurance companies, third-party payers, vendors, and regulatory agencies.
Required Qualifications:
Ability to motivate staff to achieve desired results.
Sound understanding of Joint Commission and other applicable regulatory requirements for compliance monitoring.
Capacity to maintain a work pace appropriate to the workload.
Excellent written and verbal communication skills in English.
Demonstrated experience building competency and developing skills of others.
Experience working with contracts, applying terms and conditions to claims, and performing split billing as required by Contracted Payers and DOFRs.
Working knowledge of billing commercial claims, workers compensation, managed care, and all other third-party payers.
Detailed understanding of billing technical elements such as standard forms, data elements, coordination of benefit and third-party liability billing and collection, electronic billing, data edit programs, and reimbursement methodologies (DRGs, Case Rate, Percent of Charges, capitation).
Thorough knowledge of healthcare billing, finance, and compliance, with a strong understanding of facility billing systems.
Extensive knowledge of governmental compliance rules and issues related to healthcare billing, collection, and reimbursement.
Self-directed and organized with superior analytical and problem-solving skills.
Five (5) years' experience in a revenue-based healthcare industry, such as admissions, registration, billing/collections, or contracting.
Five (5) years' experience in the management of Patient Financial Services.
Experience in PFS Operations within an Academic Medical Center organization or complex teaching environment.
Working knowledge of billing, follow-up, and denial management of commercial claims, workers compensation, managed care, and all other third-party payers.
Must possess the skills, knowledge, and ability essential to the successful performance of assigned duties.
Bachelor's Degree in a related field.
Preferred Qualifications:
Master’s degree in Health Care Management, Business, Finance, or Accounting.
Experience in PFS Operations within University and medical center organizations, including familiarity with policies, procedures, and forms.
Prior management experience of union-represented staff.
Knowledge of University and medical center organizations, policies, procedures, and forms.