AR & Billing Operations
- Supervise daily AR follow-up and medical billing activities across assigned clients or specialties.
- Monitor claim submission processes to ensure clean claim rates and timely billing.
- Review aging reports and prioritize high-value and timely filing accounts.
- Oversee denial management, appeals, corrected claims, and payment variance analysis.
- Ensure resolution of escalated payer issues and complex claim scenarios.
- Track payer trends and implement corrective action plans to reduce denials and AR days.
- Coordinate with coding, credentialing, authorization, and payment posting teams for issue resolution.
- Ensure adherence to payer guidelines, compliance standards, and client SLAs.
Team Management
- Lead, mentor, and manage AR and billing associates/senior associates.
- Monitor team productivity, quality, attendance, and performance metrics.
- Conduct regular team huddles, audits, and feedback sessions.
- Support hiring, onboarding, and training initiatives for new team members.
- Develop performance improvement plans and coaching strategies where required.
- Ensure backup planning and workload distribution within the team.
Client & Process Management
- Participate in client calls and provide operational updates and KPI reports.
- Prepare and review weekly/monthly operational dashboards and AR reports.
- Identify process gaps and implement workflow improvements and automation opportunities.
- Maintain strong communication with internal departments and external payer representatives.
- Support transition activities, process documentation, and SOP maintenance.
Compliance & Quality
- Ensure HIPAA compliance and data confidentiality standards are maintained.
- Perform quality audits on claims, denials, and follow-up activities.
- Monitor adherence to internal quality benchmarks and operational targets.
- Ensure accurate account documentation within billing systems.
Technical Skills
- Experience with EMR/EHR and billing platforms such as Cernar, Epic, ECW, Athena, NextGen, Kareo, etc.
- Familiarity with clearinghouses like Waystar, Availity, Office Ally, Change Healthcare, etc.
- Proficiency in Microsoft Excel, reporting, and operational dashboards.
Required Skills
- Strong leadership and people management skills
- Excellent analytical and decision-making abilities
- Effective communication and stakeholder management
- Strong problem-solving and escalation handling skills
- Ability to manage multiple priorities in a fast-paced environment
- High attention to detail and process orientation
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