Director of Patient Billing Services SMS-3796

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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*

Examples of Duties

20%

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.

Leads and mentors denial management and follow-up teams, establishing productivity standards, performance expectations, and professional development plans.

20%

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

20%

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

15%

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

5%

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

5%

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

5%

Performs other related duties as needed

Qualifications

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.

Supplemental Information

If you require assistance, please contact the Office of Human Resources at ***email_hidden*** or call 217-545-0223 Monday through Friday, 8:00am-4:30pm.

The mission of Southern Illinois University School of Medicine is to optimize the health of the people of central and southern Illinois through education, patient care, research and service to the community.

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Southern Illinois University School of Medicine is an Affirmative Action/Equal Opportunity employer who provides equal employment and educational opportunities for all qualified persons without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, protected veteran status or marital status in accordance with local, state and federal law.

Pre-employment background screenings required.