I have over five years of experience in revenue cycle management, primarily in healthcare settings. My role involved overseeing the entire revenue cycle process, from patient registration to claims submission and follow-up. I have successfully implemented process improvements that reduced denials by 20% and increased cash flow by 15%. My expertise includes working with various billing systems and ensuring compliance with insurance regulations.

Handling denials and rejections involves a systematic approach. First, I analyze the root cause of the denial, whether it's coding errors, insufficient documentation, or insurance-related issues. Then, I work with the billing team to correct the errors and resubmit the claims promptly. I also implement preventive measures, such as regular training sessions and audits, to minimize future denials. My goal is to ensure that every claim is processed accurately and efficiently.

Improving cash flow involves several strategies. I focus on reducing the average days in accounts receivable by accelerating the billing process and following up on unpaid claims more aggressively. I also negotiate favorable payment terms with insurance companies and implement automated reminders for patients with outstanding balances. Additionally, I monitor key performance indicators (KPIs) regularly to identify and address any bottlenecks in the revenue cycle.

Ensuring compliance involves staying updated with the latest insurance regulations and coding standards. I conduct regular training sessions for the billing team to keep them informed about any changes. I also implement internal audits to verify that all claims are coded correctly and submitted in accordance with the regulations. Furthermore, I maintain a robust documentation system to support all billing activities and facilitate any necessary audits by external agencies.

In my previous role, we faced a significant increase in claim denials due to a new insurance policy change. To resolve this, I first conducted a thorough analysis to understand the specific reasons for the denials. Then, I organized targeted training sessions for the billing team to address the new requirements. Additionally, I worked closely with the insurance company to clarify any ambiguities. As a result, we were able to reduce the denial rate by 30% within three months.