Sr RCM Director
7 days ago
- ARManagement:
- Lead the AR team inmanaging the entire AR lifecycle including claim submission paymentposting followup and resolution of outstandingbalances.
- Utilize advanced Excel skills andfinancial lookup techniques to analyze AR data identify trends anddevelop actionable insights to enhance revenueperformance.
- Implement strategies to acceleratecash flow reduce AR aging and improve collectionrates.
- Conduct regular reviews of AR reportsand metrics to track performance and identify areas forimprovement.
- DenialManagement:
- Develop and maintaina comprehensive denial management program to minimize claim denialsand maximize reimbursement.
- Investigate rootcauses of denials collaborate with relevant stakeholders to addressunderlying issues and implement correctiveactions.
- Utilize data mining and analysistechniques to identify patterns in denial trends and developproactive solutions to prevent futuredenials.
- Implement best practices and industrystandards to optimize denial appeals and resolutionprocesses.
- ProcessImprovement:
- Define and documentAR and denial management processes from ground up ensuring clarityefficiency and compliance with regulatoryrequirements.
- Identify opportunities forautomation and workflow optimization to streamline operations andenhance productivity.
- Collaborate withcrossfunctional teams including IT finance and clinical departmentsto implement process improvements and drive organizationalefficiency.
- TeamLeadership:
- Provide leadershipguidance and mentorship to the AR and denial management teamfostering a culture of accountability collaboration and continuouslearning.
- Set performance goals conduct regularperformance evaluations and provide constructive feedback tosupport professional development andgrowth.
- Foster a positive work environment thatpromotes teamwork innovation and excellence in AR and denialmanagement.
- Manage theRCM process for clients including auditing both internal andexternal medical billing procedures.
- Identifyand resolve billing issues with insurance companies ensuring timelyresolution to prevent revenue loss.
- Implementprocesses to flag overbilling or underbilling instances maintainingaccuracy and compliance.
- Act as aliaison between patients healthcare providers and insurancecompanies addressing billing benefits and insurancerelatedinquiries or issues.
- Ensure smoothcommunication and resolution of disputes optimizing revenuecollection and customersatisfaction.
- Coordinatebilling and collection activities to ensure timely and accurateinvoicing and payment collection.
- Monitoraccounts receivable activity identify outstanding balances andimplement strategies to minimizedelinquency.
- Financial CloseOversight:.
- Ensureaccurate billing of insurance providers and patients adhering tobilling guidelines and regulations.
- Documentmedical billing denials from insurance providers analyze rootcauses and implement correctiveactions.
- Analytic &Technical Ability and DataMining
- Proficient in identifyingprocess automation opportunities and screening themeffectively.
- Skilled in coordinating andcommunicating with developers to articulate technical features andrequirements actively participating in demos and proof ofconcepts.
- Capable of analyzing large andintricate datasets discerning patterns and trends to facilitateinformed decisionmaking.
- Experienced introubleshooting issues and adept at communicating effectivelyacross relevantteams..
- Bachelorsdegree in Healthcare Administration Business Finance or relatedfield; Masters degree preferred.
- Minimum of 10years of experience in revenue cycle management with a focus on ARand denial management in a healthcaresetting.
- Strong proficiency in Microsoft Excelincluding advanced functions such as VLOOKUP pivot tables and dataanalysis.
- Proven track record of success inoptimizing AR performance reducing denials and improving revenueoutcomes.
- Indepth understanding of healthcarebilling and reimbursement processes including knowledge of payerguidelines and regulations.
- Excellentanalytical problemsolving and decisionmaking skills with theability to translate data into actionableinsights.
- Strong leadership and team managementskills with the ability to inspire and motivate teams to achievegoals and objectives.
- Exceptional communicationand interpersonal skills with the ability to collaborateeffectively with internal and externalstakeholders.
rcm,data,denials,insurance,healthcare,revenuecycle,management,excel,revenue
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