PATIENT FINANCIAL SERVICES SUPERVISOR

Position Title: Patient Financial Services Supervisor

Department: Business Office

Supervisor’s Title: Revenue Cycle Manager

Position Summary

The Patient Financial Services Supervisor oversees the daily operations of billing, collections, payment posting, accounts receivable follow-up, denial management, appeals, financial assistance, prior authorizations, and medical records functions. This position is responsible for ensuring timely and accurate reimbursement, maintaining regulatory compliance, improving cash collections, reducing denials, and supporting an exceptional patient financial experience.

The Patient Financial Services Supervisor provides leadership, training, coaching, and performance management for assigned staff while monitoring key performance indicators related to accounts receivable, denials, prior authorizations, financial assistance, cash collections, and medical records operations. This position serves as a subject matter expert for back-end revenue cycle functions and works collaboratively with Patient Access, Coding, Clinical Operations, and Leadership to improve organizational financial performance and patient service outcomes.

The position communicates escalated issues and operational concerns to the Revenue Cycle Manager and provides recommendations for process improvement, workflow optimization, and revenue cycle performance enhancement.

Principal Functions and Responsibilities

1. Leadership & Operational Oversight
   1. Directs and coordinates daily activities and workflow for Patient Financial Services and Medical Records functions.
   2. Provides direct supervision, coaching, mentoring, training, and performance management for assigned staff.
   3. Manages staffing schedules and ensures appropriate coverage for billing, collections, financial assistance, prior authorization, and medical records functions.
   4. Establishes initial and ongoing training standards to ensure staff maintain competency in payer requirements, reimbursement regulations, compliance standards, and departmental workflows.
   5. Serves as the escalation point for complex patient account issues, reimbursement concerns, denials, financial assistance determinations, and medical records matters.
   6. Demonstrates exceptional customer service and professionalism while fostering a culture of accountability, teamwork, and continuous improvement.
2. Billing, Claims & Accounts Receivable Management
   1. Oversees claim submission processes to ensure timely, accurate, and compliant billing.
   2. Monitors claim edits, rejections, and payer correspondence to ensure prompt resolution.
   3. Oversees billing operations to ensure timely, accurate, and compliant claim submission, including monitoring unbilled accounts, claim quality, and billing turnaround times.
   4. Monitors reimbursement trends and identifies opportunities to improve revenue cycle performance.
   5. Coordinates with payers, clearinghouses, vendors, and internal departments to resolve claim issues and optimize reimbursement.
   6. Assists in the development and implementation of workflow improvements designed to increase efficiency and reduce revenue leakage.
3. Denials Management & Appeals 
   1. Oversees denial management activities including identification, investigation, correction, and resolution of denied claims.
   2. Monitors denial trends and develops corrective action plans to reduce avoidable denials.
   3. Coordinates appeal processes and ensures supporting documentation is submitted timely and accurately.
   4. Collaborates with Coding, Patient Access, Clinical Operations, and providers to address root causes of denials.
   5. Tracks denial metrics and reports findings, trends, and improvement opportunities to the Revenue Cycle Manager.
4. Financial Assistance & Patient Collections 
   1. Oversees administration of Valor Health's Financial Assistance Program and ensures compliance with applicable federal, state, and organizational requirements.
   2. Ensures patient accounts are handled consistently, professionally, and in accordance with approved collection policies.
   3. Reviews financial assistance applications and supports staff in determining eligibility.
   4. Monitors patient collection activities and works to improve account resolution while maintaining a positive patient experience.
   5. Provides guidance to patients regarding financial assistance options, payment arrangements, and account resolution processes.
   6. Maintains knowledge of applicable regulations related to patient billing, collections, charity care, and financial assistance.
   7. Ensures financial assistance applications, eligibility determinations, patient notifications, and appeals are processed consistently and within established timeframes in accordance with organizational policies and applicable regulations.
5. Prior Authorization Management 
   1. Oversees prior authorization workflows to ensure required authorizations are obtained timely and accurately.
   2. Monitors authorization-related denials and collaborates with departments to reduce reimbursement risk.
   3. Maintains knowledge of payer-specific authorization requirements and communicates changes to staff and leadership.
   4. Works collaboratively with clinical departments, providers, and payers to resolve authorization issues and prevent delays in care.
   5. Tracks authorization performance metrics and identifies opportunities for process improvement.
6. Medical Records & Regulatory Compliance
   1. Oversees daily medical records operations including release of information, record retention, record maintenance, and document management activities.
   2. Ensures compliance with HIPAA, patient privacy requirements, medical records regulations, and organizational policies.
   3. Monitors medical record requests to ensure timely and accurate processing.
   4. Collaborates with Coding, Compliance, Clinical Operations, and Information Technology staff regarding documentation and record management processes.
   5. Assists with audits, regulatory reviews, accreditation activities, and requests for documentation.
   6. Maintains confidentiality and security of patient information in accordance with federal and state regulations.
7. Quality Assurance & Performance Monitoring
   1. Conducts routine audits and reviews of departmental processes, workflows, and staff performance.
   2. Monitors key performance indicators, including cash collections, accounts receivable days, clean claim rates, denial rates, appeal success rates, authorization performance, financial assistance activity, and medical records turnaround times. Identifies performance deficiencies, develops corrective action plans, and monitors progress toward established departmental goals.
   3. Uses audit findings and performance data to identify training opportunities and process improvements.
   4. Participates in continuous quality improvement and continuous learning activities.
   5. Develops and distributes operational reports as requested by leadership.
8. Policy, Compliance & Interdepartmental Collaboration 
   1. Ensures compliance with CMS regulations, CAH requirements, HIPAA, Idaho Patient Act requirements, payer contracts, and Valor Health policies.
   2. Acts as a liaison between internal departments, external payers, vendors, and business partners to improve operational effectiveness.
   3. Participates in the development and revision of departmental goals, objectives, policies, and procedures.
   4. Collaborates with the Revenue Cycle Manager, CFO, Patient Access leadership, Coding, Clinical Operations, and other departments to improve revenue cycle performance.
9. Additional Duties
   1. Conducts and participates in department and interdepartmental meetings.
   2. Ensures compliance with all Valor Health policies and procedures.
   3. Performs other duties as assigned.

Qualifications

Position Qualifications/Requirements/Preferences:

1. Position Qualifications
   1. High school diploma or equivalent required.
   2. Minimum of three (3) years of progressively responsible experience in healthcare revenue cycle operations, patient financial services, medical records, or related healthcare business functions.
   3. Minimum of one (1) year of leadership, supervisory, lead, or team coordination experience.
2. Requirements
   1. Demonstrated knowledge of healthcare billing, collections, accounts receivable follow-up, denial management, financial assistance programs, and reimbursement processes.
   2. Working knowledge of Medicare, Medicaid, commercial insurance, managed care, and payer reimbursement methodologies.
   3. Knowledge of Critical Access Hospital (CAH) and Rural Health Clinic (RHC) reimbursement principles.
   4. Knowledge of HIPAA, patient privacy requirements, release of information processes, and medical record retention requirements.
   5. Ability to interpret payer policies, reimbursement regulations, and contractual requirements.
   6. Strong leadership, coaching, mentoring, and employee development skills.
   7. Strong organizational, analytical, problem-solving, and decision-making abilities.
   8. Excellent written, verbal, and interpersonal communication skills.
   9. Ability to manage multiple priorities, meet deadlines, and adapt to changing operational demands.
   10. Proficiency with electronic health records, revenue cycle systems, Microsoft Office applications, and other healthcare technology platforms.
   11. Ability to maintain confidentiality and exercise sound judgment in handling sensitive patient and organizational information.
3. Preferences
   1. Associate's or Bachelor's degree in Healthcare Administration, Business Administration, Accounting, Finance, Health Information Management, or a related field.
   2. Experience in a Critical Access Hospital (CAH), Rural Health Clinic (RHC), Federally Qualified Health Center (FQHC), or other rural healthcare environment.
   3. Previous supervisory experience overseeing billing, collections, denial management, prior authorizations, financial assistance, or medical records functions.
   4. Experience with Epic, Cerner CommunityWorks, or Cerner Millennium.
   5. Experience utilizing revenue cycle reporting tools, analytics platforms, clearinghouse systems, and payer portals.
   6. Professional certification such as:
      1) Certified Revenue Cycle Representative (CRCR)
      2) Certified Professional Biller (CPB)
      3) Certified Healthcare Financial Professional (CHFP)
      4) Registered Health Information Technician (RHIT)
   7. Experience participating in process improvement initiatives, accreditation surveys, regulatory audits, or revenue cycle optimization projects.

Physical Requirements

1. Ability to perform duties in a professional office environment, including prolonged periods of sitting and computer use.
2. Occasional standing, walking, bending, reaching, and lifting of office materials weighing up to 25 pounds.
3. Ability to operate standard office equipment, including computers, telephones, printers, and scanners.
4. Ability to communicate effectively in person, by telephone, and through electronic communication.
5. Ability to perform the essential functions of the position, with or without reasonable accommodation.