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Director of Patient Billing Services SMS-3796
Southern Illinois University - School of Medicine
Details
Posted: 17-Apr-26
Location: Springfield, IL
Categories:
Staff/Administrative
Internal Number: 5310713
Under administrative direction, the Director of Patient Billing Services (PBS) plans, develops, directs, coordinates, and evaluates all operational and program activities related to patient billing operations (back-end revenue cycle). This includes oversight of the insurance denials management and follow-up team, cash management, payment posting, refunds team, and patient/customer service teams. The Director ensures efficient revenue cycle performance, regulatory compliance, financial integrity, customer satisfaction, and continuous process improvement across all patient billing operations.
This position provides support to the Executive Director of Revenue Cycle as well as any Directors and Managers who oversee PBS operations.
*This position is ON SITE only*
Directs Insurance Denials and Follow-Up Operations
- Provides strategic and operational leadership for denial prevention, denial management, appeals, and insurance follow-up functions.
- Establishes and oversees policies, workflows, and performance standards to ensure timely follow-up and optimal reimbursement outcomes.
- Monitors denial trends, payer performance, and root causes; implements corrective action plans to reduce denials and improve revenue integrity.
- Partners with coding, clinical departments, contracting, compliance, and revenue cycle leadership to improve clean claim rates and strengthen denial prevention strategies.
- Defines and tracks key performance indicators (KPIs) including denial rates, AR days, aging, and payer trends; leverages analytics and reporting to identify improvement opportunities and drive operational performance.
Oversees Cash Management, Payment Posting, and Refunds
- Provides strategic oversight for cash management operations, including payment posting, reconciliations, adjustments, and refund processing.
- Establishes policies, workflows, and performance standards to ensure the accurate and timely posting of insurance and patient payments.
- Implements and maintains internal controls to safeguard financial integrity, ensure regulatory compliance, and prevent revenue leakage.
- Oversees credit balance resolution and refund processes to ensure compliance with federal and state regulations as well as payer requirements.
- Collaborates with Finance to support account reconciliation processes and ensure accurate financial reporting
Leads Patient Billing Customer Service Operations
- Provides strategic leadership for patient billing customer service operations, including oversight of call center performance and patient account support functions.
- Establishes service standards, operational metrics, and performance expectations to ensure a high-quality patient financial experience.
- Develops and implements policies and procedures that promote consistent, compassionate, and compliant communication with patients regarding their financial responsibilities.
- Directs training and quality assurance programs to improve customer service performance, staff competency, and first-call resolution rates.
- Oversees escalation processes for complex billing concerns and patient complaints, ensuring timely resolution and continuous improvement of service delivery
Strategic Leadership and Operational Improvement
- Develops and implements strategic plans to improve billing efficiency, cash flow, and patient experience.
- Analyzes revenue cycle performance metrics and implements process redesign initiatives.
- Leads automation, system optimization, and workflow improvement efforts.
- Partners with IT and Revenue Cycle leadership to optimize billing system functionality
Policy Development and Regulatory Compliance
- Develops, interprets, and enforces policies and procedures related to billing, collections, refunds, and customer service.
- Ensures compliance with CMS regulations, payer contracts, HIPAA, and other federal and state billing requirements.
- Oversees audit response activities and implements corrective action plans as necessary
Supervisory Responsibilities
- Provides leadership and oversight to directors and managers and staff within insurance follow up/denials, cash management and posting, and customer service teams.
- Helps to determines staffing need and organizational structure.
- Conducts performance evaluations and supports staff development.
- Promotes accountability, productivity, and team engagement
Required Qualifications
- Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or a related field.
- Eight (8) years of progressively responsible experience in healthcare revenue cycle operations.
- Five (5) years of supervisory or management experience in patient billing, accounts receivable, or related revenue cycle functions.
Desired Qualifications
- Master's degree in Healthcare Administration, Business Administration, Finance, or related field.
- Professional certification such as HFMA Certified Revenue Cycle Representative (CRCR), Certified Healthcare Financial Professional (CHFP), or similar revenue cycle certification.
- Experience in an academic medical center, large physician practice, or multi-specialty billing environment.
About Southern Illinois University - School of Medicine
SIU School of Medicine was established in 1970 with a mission to educate physicians for central and southern Illinois. We are a medical school with four areas of excellence: medical education, patient care, research and community service. SIU School of Medicine provides education to undergraduate medical students, medical and surgical residents, fellows, and physician assistant students. Our clinical practice, SIU Medicine, includes a team of more than 250 health care professionals including university physicians and faculty members who are collectively dedicated to providing excellent medical care, advancement of care through research, and training the next generation of physicians. As the premier provider of health care services, SIU Medicine offers both primary care and specialized treatment services including preventative and diagnostic. SIU works in partnership with hospitals and clinics throughout central and southern Illinois to meet the health care needs of our communities.
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