Overview
Oversee day-to-day operations of payor follow-up for hospital or professional billing, driving AR performance, cash acceleration, and reduction of aged inventory and avoidable denials. This role manages claim statuses, insurance follow-up, denials and underpayment workflows, and operational execution of work queues and escalation pathways, partnering with Revenue Integrity, Patient Access, HIM, Coding/CDI, Managed Care, Finance, IT and Compliance.
Qualifications
Education
- Associate degree in Healthcare Administration/Management, or related field highly preferred.
Experience
- Minimum of 3-4 years progressive revenue cycle experience, including at least 1-2 years in billing operations (HB and/or PB) in a hospital or multi-site health system with two-year degree.
- Minimum of 3 years of supervisory experience in hospital and/or professional billing operations.
- Will substitute formal degree requirements with 6+ years of direct hands-on revenue cycle and supervisory experience.
- Demonstrated experience with Epic and revenue cycle technologies.
- Proven success leading teams through organizational change and process improvement initiatives.
Other Qualifications
- Working knowledge of CMS and commercial billing rules (UB-04, CMS-1500, NCCI, MUEs, LCD/NCD).
- Strong Excel skills and basic comfort with reporting; ability to use data to monitor team performance and drive improvements.
- Knowledge of regulatory requirements (CMS, HIPAA) and basic compliance awareness.
- Strong coaching and collaboration skills; experience working cross-functionally with Coding, HIM, Patient Access, and Revenue Integrity.
- Solid communication, organization, problem-solving skills, and interpersonal skills.