Covenant Health

Patient Accounting Director, Business Office

Full Time, 80 Hours Per Pay Period, Day Shift

Experience with directing hospital business offices strongly preferred.

Covenant Health Overview:

Covenant Health is the region’s top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area’s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times. 

Position Summary:

The Director of Patient Accounting is responsible for providing strategic leadership and operational oversight for all patient accounting functions across the health system. This role ensures the effective management of accounts receivable, billing, collections, posting, cashiering, and customer service operations. The Director will lead initiatives to optimize reimbursement, improve cash collections, and ensure compliance with federal, state, and payer regulations. This position collaborates closely with hospital units, medical staff, and revenue cycle leadership to drive performance, innovation, and service excellence.

Recruiter: Suzie McGuinn || apply@covhlth.com

Strategic Leadership & Alignment

• Provides strategic direction for patient accounting operations aligned with organizational revenue cycle goals.
• Develops and implements system-wide initiatives to improve financial performance and operational efficiency.
• Collaborates with revenue cycle and financial leadership to ensure cohesive and integrated operations.
• Monitors industry trends, regulatory changes, and payer requirements to proactively adjust strategies.
• Prepares and monitors annual operating and capital budgets; ensures resource utilization aligns with financial targets.

Revenue Cycle Operations Management

• Oversees billing, collections, cashiering, and customer service functions across the enterprise.
• Ensures timely and accurate management of accounts receivable and maximizes reimbursement from third-party payers.
• Maintains accountability for system master file integrity, payer monitoring, and customer relations.
• Leads the development and implementation of policies, procedures, and internal controls to ensure compliance and operational excellence.
• Analyzes cash collections and A/R performance to identify trends and opportunities for improvement.

Compliance & Regulatory Oversight

• Ensures compliance with Medicare, Medicaid, TennCare, managed care, and other regulatory requirements.
• Communicates regulatory updates to staff and stakeholders; ensures timely implementation of changes.
• Maintains internal controls for adjustments, refunds, and cash handling processes.

Technology & Workflow Optimization

• Evaluates and implements technology solutions to enhance efficiency and accuracy in patient accounting processes.
• Ensures staff are trained on systems and that automation tools are fully utilized.
• Participates in IT steering committees and leads system-related projects as assigned.

Performance Improvement & Data-Driven Decision Making

• Establishes measurable goals and KPIs aligned with Balanced Scorecard (BSC) metrics.
• Uses data analytics to drive process improvements and enhance financial outcomes.
• Shares performance results with staff and leadership; develops action plans for underperforming areas

Leadership & Workforce Development

•  Provides leadership and mentorship to managers and staff within the patient accounting division.
• Conducts regular performance reviews and staff development planning.
• Identifies training and cross-training needs to support succession planning and professional growth.
• Fosters a culture of accountability, innovation, and continuous improvement.

Stakeholder Collaboration

• Serves as a liaison between patient accounting and hospital departments, medical staff, and executive leadership.
• Handles complex issues such as payer disputes, patient complaints, legal matters, and system challenges.
• Promotes positive relationships with internal and external stakeholders to support organizational goals.

Enterprise-Wide Initiatives & Innovation

• Leads or supports enterprise-wide initiatives related to revenue cycle transformation.
• Identifies and implements innovative solutions to improve cash collections and workflow.
• Coordinates with leadership to align departmental initiatives with broader organizational strategies.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.

Minimum Education:           

None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a Bachelor’s degree. Preference may be given to individuals possessing a Bachelor’s degree in a directly-related field from an accredited college or university.

Minimum Experience:         

Minimum of five (5) years of experience in a hospital business office or equivalent, with knowledge of Medicare, Medicaid, and third-party payer regulations.

Licensure Requirement:      

None.