- Lead day-to-day Revenue Cycle operations and oversee billing, coding, claims submission, payment posting, accounts receivable, collections, denials, appeals, and reimbursement.
- Monitor outstanding, rejected, denied, unpaid, and underpaid claims through resolution and implement corrective action plans.
- Oversee accounts receivable and collections, review aging, and establish follow-up priorities to improve cash flow.
- Analyze denial trends, conduct root-cause analysis, and manage corrected claims and appeals through resolution.
- Serve as a primary Revenue Cycle contact for health plans and payers, reconciling claims and pursuing reimbursement discrepancies.
- Conduct audits and maintain compliance with payer requirements, healthcare billing regulations, HIPAA, contractual obligations, and organizational policies.
- Develop Revenue Cycle reports, dashboards, and performance analyses, and provide updates to the Directors of Community Health & Operations.
- Supervise, coach, train, and evaluate Revenue Cycle staff; establish performance expectations and monitor productivity and quality.
- Develop and maintain Revenue Cycle policies, procedures, workflows, and standard operating procedures.
- Collaborate with Finance, Quality Assurance, Operations, program leadership, and Information Technology to address operational and reimbursement issues.
Microsoft ExcelEHRHIPAA