I have over five years of experience in revenue cycle management, primarily in hospital settings. My role involved overseeing the entire revenue cycle, from patient registration to claims submission and follow-up. I have successfully implemented process improvements that reduced denials by 15% and increased cash flow by 10%. My expertise includes working with EHR systems, understanding payer contracts, and ensuring compliance with regulatory requirements.

When discrepancies arise, I first conduct a thorough investigation to identify the root cause. This often involves reviewing patient charts, comparing billing codes with clinical documentation, and consulting with coders and clinicians. I then work collaboratively with the billing team to correct errors and ensure accurate claims submission. Regular audits and training sessions are also part of my strategy to prevent future discrepancies.

To improve cash flow, I focus on optimizing the billing process by ensuring timely and accurate claims submission. This includes regular follow-ups on pending claims and working closely with insurance companies to resolve any issues. Additionally, I implement payment plans for patients with high balances and offer financial counseling to improve patient collections. By streamlining these processes, I have been able to reduce accounts receivable days by 20%.

I stay updated by regularly attending industry conferences, webinars, and training sessions focused on healthcare regulations and revenue management. I also subscribe to relevant journals and newsletters, and I am part of professional organizations that provide updates on regulatory changes. By staying informed, I can proactively adjust our revenue management strategies to ensure compliance and minimize financial risks.

In my previous role, we faced a significant issue with a major insurance payer who was denying a high volume of claims due to a contract interpretation discrepancy. I led a cross-functional team to review the contract, engage in negotiations with the payer, and ultimately reached an agreement that reduced denials by 30%. This not only improved our cash flow but also strengthened our relationship with the payer.