Job Board

The Associate Director of Patient Financial Services (PFS) Operations and Systems serve as a strategic technical and operational leader for the technology systems and processes which drive billing and follow-up for UCSF's Hospital Billing. These systems transmit data and claims that drive more than $300M in cash collections each month. The wide responsibilities for this role span from expertise in all aspects of Epic's hospital billing system, through UCSF's claims system, to Electronic Data Interchange (EDI), through payment collection and cash management, and to all of the varied technology processes that allow UCSF to be reimbursed as quickly, efficiently, and compliantly. Establishes business analysis objectives and work plans, and directs a team of expert analysts to drive optimization of industry-leading patient accounting systems. Serves as an expert on revenue cycle systems and best practices across the organization. Specifically, the Associate Director will:

* Have overall responsibility for leadership, development, and support of all PFS-managed systems, processes, and applications. These include Pro-Fee Cash Allocations; Transplant Billing Application; Claims and Remittance Manager (Cirius); Refund Application; Letter of Agreement (LOA) Application; Ephesoft Scanning software.
* Provide recommendations to optimize all billing, follow-up, and collection functions and processes that occur in multiple systems supported by PFS Centralized Services for UCSF Health. Ensures that all systems are fully operational on a day-to-day basis to maximize effectiveness in managing the revenue cycle processes for multiple Service Areas within UCSF Health.
* Responsibility for all EDI operations for UCSF Medical Center; Children's Oakland Medical Center, UCSF Physicians Group, MGBS, and other "Connect" affiliated facilities. This includes claim editing, electronic claim submissions, claim status, and processing electronic payments.
* Advise, optimize and collaborate with key technology partners: including APeX (UCSF's branded Epic application), IT, and other revenue cycle stakeholders for Epic system upgrades, custom implementations, and process improvements.
* Establishes the system support and reporting team for the above functions and processes.
* Manage the remittance processing and Cash Management team that provides payment and adjustment processes for UCSF Health.
* Develop and implement expansion of UCSF Health Community Connect program for new facilities joining the CIN network. This includes establishing new payer enrollments for billing and remittance processes, establishing new payers and plans in the EPIC Plan Master, and testing all processes for each new facility implementation.
* Provide Cash and payment posting reconciliation processes for each entity within UCSF Health; UCSF Medical Center, Children's Oakland, UCSF Physicians Group, and all Community Connect facilities.
* Manage the Epic Payer/Plan master file providing maintenance and support for new processes and developments and providing support for the growth of the Plan master has new plans are required through new UCSF contracts or for new facilities when they are added to the Connect Program.