Wilshire hires only the brightest and most experienced professionals in the healthcare revenue cycle management industry.  Wilshire will take the time to get know you and your employment history.  We will then place you in a role that will lead to a path of career success.  

About The Wilshire Group 

The Wilshire Group, a renowned boutique consulting firm in Los Angeles, specializes in revenue cycle optimization and fostering effective collaboration between operational and IT facets.  With a robust track record of aiding over 100 healthcare systems nationwide, our team thrives on professionalism, efficiency, and adaptability.

Our core values- professionalism, efficiency, and flexibility- underscore our commitment to creating an inclusive and dynamic workplace.  We embrace diverse narratives and believe in offering opportunities to exceptional individuals who bring their best to the table.

Join us at The Wilshire Group, a place where talented professionals find a home to showcase their skills and contribute meaningfully to the healthcare landscape.

This is a contracted position for 5+ months.  Pay Range: $95-$110 per hour.

Job Summary

Patient Access & Finance Counseling Services Director

Job Description:

Responsible for patient registration, admitting, financial counseling, patient estimates, and eligibility vendor management for optimal performance of the front-end registration process/revenue cycle. Responsible for front-end data quality for the patient registration and admitting activities across all Patient Access Services and non-Patient Access Services patient-facing locations. Ensures that these functions are performed efficiently throughout the enterprise, which includes maintaining an adequately trained staff to handle all patients in both inpatient and outpatient clinic settings. Identifies and implements new and emerging strategies to increase efficiency, improve processes and financial outcomes, and enhance the patient financial experience.

What you will do:
Directs implementation of standards and systems to enhance the quality, consistency, efficiency, and timeliness of responsibilities for the enterprise on a 24/7 basis. Ensure the integrity and accuracy of registration data.

Ensures and creates a positive financial experience by helping patients navigate and understand insurance benefits and potential financial liability.Works collaboratively with other departments to ensure the processes and systems for registration, admitting, and financial counseling are standardized and optimized for efficient and effective flow of patients within the department and the organization. Plan and develop new systematic approaches to maximize upfront collections and accuracy in registrations.

Ensures admitting, registration, and financial counseling functions are performed efficiently throughout the Patient Access services, which includes maintaining an adequately trained staff to handle all patients in both inpatient and outpatient settings.

Provide input and direction to the strategic plan and goals to meet imperatives.

Participate in budget preparation and cost control management.

Keeps up-to-date on all regulatory and accrediting agency requirements, including Federal and State regulations and Joint Commission standards as they relate to Registration, Admitting, Patient Estimates, and Financial Counseling.

Ensure the accuracy and timeliness of creating patient estimates

Ensures compliance with policies and directives issued by Medicare, Medicaid, Third Party Payers, and others as needed; i.e., Medicare Secondary Payer, authorization for inpatient and outpatient services, and verification of eligibility or other primary coverage.

Assures compliance with the medical staff bylaws, rules and regulations, and hospital and departmental policies and procedures.

Ensures all productivity and benchmarking (internal and external) standards are met, and develops mitigation plans for corrective action.

Maintains a complete record of current policies and procedures followed by staff in the director’s areas of responsibility; responsible for having complete knowledge of the patient flow and steps taken by staff to complete these procedures; assures that staff are adequately trained and meet competency requirements and levels.

Manages appropriate staff levels. Develops goals and priorities, and assigns tasks and projects.

Develops staff skills and training plans. Counsels, trains, and coaches assigned staff. Implements corrective actions and conducts performance evaluations. Provides leadership, direction, and guidance.

Represents the department on various committees; conducts regular unit staff meetings.

Utilizes feedback and needs assessment tools to understand internal customer expectations. Strives to provide services that exceed expectations and works to eliminate barriers to good service.

Maintains relations with all internal applicable parties, third-party payers, and other agencies, as appropriate.

Designs, develops, and monitors performance improvement processes.

Education Qualifications
Bachelor’s degree in business, finance, health, or public administration, or a related field

Required
Master’s degree in business, health, or public administration, management, or related field strongly preferred.

Experience Qualifications
Bachelor’s degree and eight (8) years of progressively responsible and related work experience or master’s degree and five (5) years progressively responsible and related work experience.

Epic experience in a large academic health system or integrated delivery network (IDN).

NAHAM certification within 1 year Preferred

Required Knowledge, Skills and Abilities

The director must have a clear understanding of multiple managed care contracts, multiple specialty insurance and billing practices, and exercise professional competency in reviewing patient accounts to maximize reimbursement and minimize financial risk.

Successful oversight will result in increased net revenues by reducing bad debt from potential write-offs due to lack of eligibility and denials. Interactions will primarily be conducted with both patients & payors, and results of efforts will drive actions to secure payment for scheduled and unscheduled patients. Serves as a resource to faculty, managers, and clinic staff in all financial clearance-related issues.

Exceptional communication skills, ability to explain, advocate, and express facts and ideas in a convincing manner, and negotiate with individuals and groups internally and externally.

Emotionally intelligent and tactful in all situations

Superior presentation skills, able to present in a clear and articulate fashion in front of a variety of constituents.

Commitment to a “team approach” and encourages collaborative process, working effectively with a diverse or multi-disciplinary group to achieve a common goal.

Demonstrated knowledge and understanding of Epic Cadence and Prelude.

Demonstrated knowledge and understanding of governmental and non-governmental requirements applicable to registration, admitting and financial counseling.

Demonstrated abilities in utilizing Lean/Project Management protocols for efficient workflows.

Works independently with strong follow-up skills to ensure effective and efficient completion of tasks.

Adapts to change, plans/influences strategies to the organization’s political realities and constraints.

Seek to understand disagreements, ensure all perspectives are heard, and facilitate a plan for resolution.

Outstanding relationship management skills, easily builds strong and effective working relationships within a climate of trust, inspires cooperation and confidence and is a true consensus builder.

Ability to maintain effective working relationships with all employees and upper management.

Demonstrated skill in receiving and disseminating information effectively and appropriately, reviewing and acknowledging unit communication.

Knowledge of relevant Hospital Policies, Practices, No Surprises Act, and HIPAA regulations.

Knowledge of and ability to utilize Microsoft Excel, Word, Project, or other spreadsheet and/or word processing software.

Work independently with strong follow-up skills to ensure effective and efficient completion of tasks.

Organizational Savviness: understanding the culture of the organization, how work gets done, how the role’s decisions impact across the organization, the interdependence of operations, the priorities, and the goals and objectives of the organization.
Licenses and Certifications
NAHAM certification within 1 year preferred.

Wilshire is honored that you have taken the time to review/apply to our open position.  We will now take the time to review your experience and be in touch with you soon.