I have over five years of experience in revenue cycle management, primarily in healthcare settings. I've managed end-to-end revenue cycle processes, including patient registration, insurance verification, charge capture, claims submission, and follow-up on denied claims. My role involved ensuring compliance with regulatory requirements and optimizing workflows to enhance cash flow and reduce denials.

I approach denials systematically by first categorizing them based on the reason for denial. I then prioritize high-impact denials and work closely with the billing team to address root causes. Implementing regular training sessions and updating standard operating procedures helps in reducing future denials. Additionally, I use analytics to predict and prevent potential denials before they occur.

To improve cash flow, I focus on reducing the average days in accounts receivable by streamlining billing processes and enhancing follow-up on unpaid claims. I also advocate for early payment discounts and prompt payment incentives for patients. Regularly reviewing and updating payer contracts to ensure competitive reimbursement rates is another key strategy.

Ensuring compliance involves staying updated with the latest healthcare regulations and guidelines. I conduct regular audits to verify that all processes align with these regulations. Additionally, I provide training to the team on compliance issues and implement robust documentation practices to safeguard against non-compliance. Regular reporting to management helps in maintaining a proactive approach to regulatory changes.

In my previous role, I encountered a significant increase in claim denials due to incorrect coding. I led a cross-functional team to analyze the issue, identify the root cause, and implement a corrective action plan. This included retraining the coding staff, updating our coding software, and establishing a new audit process for coding accuracy. Within three months, we saw a 40% reduction in denials related to coding errors.