I have extensive experience with various revenue cycle management systems, including Epic, Cerner, and Meditech. My role involved not only mastering the functionalities of these platforms but also optimizing their use to streamline billing processes and reduce claim denials. I have successfully implemented system upgrades and trained staff on new features, ensuring that our team could efficiently manage patient accounts and revenue collection.

Handling disputes and denials requires a systematic approach. I first analyze the root cause of the denial, whether it's coding errors, insufficient documentation, or billing issues. Then, I work closely with the billing team and coders to rectify the errors and resubmit claims. I also ensure that we implement preventive measures to avoid similar issues in the future, such as updating training protocols or enhancing our pre-billing checks.

To improve cash flow, I focus on reducing the billing cycle time and increasing the accuracy of claims submissions. This involves implementing efficient follow-up procedures for outstanding claims, optimizing payment plan options for patients, and leveraging analytics to identify bottlenecks in the process. Additionally, I advocate for early engagement with patients regarding their financial responsibilities, which helps in timely payments.

Ensuring compliance involves staying updated with the latest healthcare regulations and guidelines, such as HIPAA and CMS rules. I conduct regular audits of our billing practices and documentation to ensure they meet regulatory standards. I also provide training to the team on compliance issues and collaborate with our legal department to address any potential risks promptly.

In my previous role, I encountered a significant increase in claim denials due to incorrect coding. I led a cross-functional team to review our coding practices and identified several areas for improvement. We implemented new training programs for coders and introduced a peer-review process for complex cases. This initiative not only reduced denials by 30% but also improved our overall coding accuracy.