Strategic Account Oversight and Client Relationship Management

Serve as the primary RCM contact for high-value accounts, maintaining proactive and open communication to address client needs and expectations.

Develop and maintain strong client relationships, conducting regular meetings with strategic accounts to review performance metrics, address concerns, and discuss revenue optimization strategies.

Monitor and analyze account performance, ensuring that metrics such as AR aging, clean claim rates, and denial overturns meet or exceed industry benchmarks and client expectations.

Team Leadership and Development

Lead, mentor, and manage a team of RCM specialists, providing guidance and support to improve team performance and ensure alignment with account-specific goals.

Set and track team objectives, ensuring that team members meet performance metrics and follow best practices in claims processing, billing, denial resolution, and collections.

Conduct regular one-on-one and team meetings to review account progress, provide feedback, and support individual development within the RCM team.

Claims Processing and Denial Management

Oversee the claims management process for strategic accounts, ensuring timely submission, accurate payment posting, and effective denial follow-up to maximize revenue collection.

Work closely with team members and other departments to resolve complex claim issues and develop strategies to reduce denial rates and improve claims accuracy.

Implement account-specific denial management processes, using data analysis to identify and address common reasons for denials and reduce recurring issues.

Process Improvement and Compliance

Analyze RCM processes and workflows, identifying areas for improvement to enhance efficiency, reduce AR days, and increase collections for strategic accounts.

Ensure compliance with federal, state, and payer-specific regulations across all RCM functions, maintaining a high standard of data security and patient confidentiality.

Collaborate with management to develop and implement best practices in RCM workflows, focusing on continuous improvement and achieving industry-standard performance for strategic accounts.

Reporting and Data Analysis

Prepare and present performance reports, including AR aging, denial rates, and clean claim rates, to internal stakeholders and clients, offering insights and recommendations to improve revenue cycle performance.

Use data analysis to monitor KPIs and identify trends across strategic accounts, making data-driven decisions to support optimal account management and client satisfaction.

Maintain accurate records of account activities and metrics, ensuring timely and transparent reporting to both internal leadership and client stakeholders.