Senior Manager - Hospital Billing, AR

Qualifications:

-Extensive knowledge of US hospital billing and accounts receivable calling workflows, insurance claim management (commercial, Medicare, Medicaid), denials management, and collections processes for 10 years.

-Proven ability to lead large teams (onshore/offshore) and coordinate complex revenue cycle operations.

-Strong client relationship management skills with experience acting as the primary client liaison and trusted advisor.

-Expertise in analyzing and interpreting key revenue cycle metrics including cash collections, denial rates, days in A/R, DNFB (discharged not final billed), and bad debt.

-Experience developing and implementing strategic plans to improve operational efficiency, reduce denials, decrease days in A/R, and optimize cost to collect.

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Client Management:

-Serve as the primary point of contact for assigned healthcare provider clients, establishing and maintaining trusted, long-term relationships.

-Understand client business objectives and challenges to tailor service delivery and recommend revenue cycle improvements.

-Conduct regular client review meetings to present performance reports, KPIs, and strategic recommendations aligned with client goals.

Operational Leadership:

-Oversee daily operations of hospital revenue cycle services including patient access, billing, coding, charge capture, AR calling, and collections.

-Ensure all services meet or exceed agreed Service Level Agreements (SLAs) and quality standards.

-Lead and manage multidisciplinary service delivery teams, including onshore and offshore resources, empowering staff and fostering collaboration.

Process Improvement & Strategic Planning:

-Identify operational gaps and lead continuous improvement initiatives aimed at reducing denials, decreasing days in A/R, and lowering the cost to collect.

-Develop and execute strategic plans that drive revenue cycle performance and enhance client satisfaction.

-Partner with technology and analytics teams to implement automation solutions, reporting tools, and system enhancements supporting operational goals.

Performance Management:

-Monitor and analyze key revenue cycle performance indicators such as cash collections, denial rates, accounts receivable aging, DNFB status, and bad debt.

-Develop and maintain dashboards and reporting tools for internal leadership and client stakeholders.

-Utilize data-driven insights to inform decision-making and optimize revenue cycle processes continuously.

Compliance & Quality Assurance:

-Ensure managed services operations comply with all applicable healthcare regulations and payer requirements (e.g., HIPAA, CMS).

-Implement and oversee Quality Assurance (QA) processes to maintain accuracy, compliance, and high standards in billing and collection activities.

-Maintain up-to-date knowledge of federal and state regulatory requirements impacting revenue cycle operations.