Manager Patient Financial Services - Pharmacy - Home Care

King Of Prussia, PA, US, 19408

Location: LOC_HORIZON-Horizon 

Req ID: 95753

Shift: Days

Employment Status: Regular - Full Time 

Job Summary

Responsible for oversight of the patient financial services functions, including pre-certification, coding, billing, communication with third party payors, cash posting, collections, denial management , revenue cycle analytics, and other issues for CHOP Specialized Pharmacy and Home Care services .  Provide leadership in audit methods and procedures of Business Office functions to improve efficiency and ensure compliance with organizational and governmental regulations.  Establish, implement, and monitor quality and productivity performance measures for the revenue cycle team.  This position is also responsible for measuring and monitoring the electronic claim acceptance rate metrics and managing all efforts to ensure consistent data flow between CHOP, any third party scrubber, and ultimately the payors. 

Job Responsibilities

  • Provide leadership and strategic direction for the patient financial services function.
  • Key partner to both the Senior Director of Home Care Services and Director of Specialty Pharmacy
  • Collaborates with Home Care Patient Access, Financial Counselors, Case Management, Audit and Compliance, Department Clinical Teams, and other areas of Home Care and Specialized Pharmacy Services to ensure that revenue cycle flows efficiently and effectively.
  • Manages and negotiates single case rate agreements and Global Case Rate contracts, including billing and collection to insure reimbursement is at the correct contracted rate. 
  • Monitors KPI performance against cash targets and develops strategies to achieve goals.
  • Maintains month end reporting to support monthly close.
  • Create partnership with Manager – Patient Financial Services Billing
  • Performs various analytics to understand payor trends and collection performance
  • Develops and maintains a high-performing team of revenue cycle professionals including but not limited to insurance verification, pre-registration, financial counseling, coding, billing, collections, denials/underpayments, customer service, and vendor management to drive improved financial performance at a lower cost-to-collect
  • Manages Revenue Cycle technology for Home Care and Specialized Pharmacy
  • Updates and maintains payor contracts, credentialing, MAP reconciliations, and acts as administrator for all payor website resources.

Required Licenses, Certifications, Registrations

Required Education and Experience

Required Education: Bachelor’s Degree


Required Experience:  Five (5) years of leadership experience in Patient Financial Services billing

Preferred Education, Experience & Cert/Lic

Preferred License: Certified Revenue Cycle Representative  (CRCR) from the HFMA

Additional Technical Requirements

  • Superb leadership qualities; a consensus builder able to work both independently and collaboratively.
  • Action oriented; proven track record of achieving agreed-upon goals.
  • Facilitator with excellent presentation skills.
  • Highly energetic with a collaborative style.
  • Extremely skilled communicator with a style that engenders trust and accountability with those with whom he/she works.
  • Thinks proactively and strategically with sound business and strategic planning skills.
  • Ability to maneuver through complex political situations effectively and quietly; informal influence skills.
  • Emphasizes team goals with a common purpose and seeks win-win solutions.  Takes ownership for projects, programs and services, and accepts accountability for results.
  • Strong sense of ethics consistent with those of The Children's Hospital of Philadelphia. 
  • Project management skills.
  • Solid working knowledge of process innovation methodology.

All CHOP employees who work in a patient building or who provide patient care are required to receive an annual influenza vaccine unless they are granted a medical or religious exemption.

Children's Hospital of Philadelphia is committed to providing a safe and healthy environment for its patients, family members, visitors and employees. In an effort to achieve this goal, employment at Children's Hospital of Philadelphia, other than for positions with regularly scheduled hours in New Jersey, is contingent upon an attestation that the job applicant does not use tobacco products.

Children's Hospital of Philadelphia is an equal opportunity employer. We do not discriminate on the basis of race, color, gender, gender identity, sexual orientation, age, religion, national or ethnic origin, disability or protected veteran status.

VEVRAA Federal Contractor/Seeking priority referrals for protected veterans.  Please contact our hiring official with any referrals or questions.

CHOP Careers Contact 

Talent Acquisition

2716 South Street, 6th Floor

Philadelphia, PA 19146 




Nearest Major Market: Philadelphia

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