RIA
RCM AR & Denials Process Lead
RCM AR & Denials Process Lead | Englewood, CO Reports to RCM Manager Employment Type: Full Time Radiology Imaging Associates (RIA) is comprised of over 115 radiologists. All with exceptional skill and expertise, most are fellowship-trained in their field of specialty for additional certification. We are dedicated to accurate and efficient patient diagnosis no matter their condition. Our interventional radiologists perform some of the most leading-edge treatments available today. We partner with primary care physicians and hospitals across Colorado, Nebraska, and Hawaii to provide a resource for both patients and physicians. Position Summary: The AR & Denials Process Lead is responsible for overseeing and optimizing the workflows related to insurance denials, aged accounts, and accounts receivable (AR) follow-up. This role ensures that best practices are implemented to improve revenue collection and reduce denials, while also serving as a subject matter expert and collaborator across teams. This is a process-focused role and does not include direct personnel management. Key Responsibilities: Denial Management & Resolution: Analyze and identify trends in denials and AR delays to develop strategies for reducing avoidable write-offs. Work closely with the billing team, authorization team, and outsourced billing partners to ensure effective and timely follow-up on denied claims. Monitor payer trends and changes in policies to proactively adjust processes and reduce future denials. Process Improvement & Optimization: Develop and implement standard operating procedures (SOPs) for denial management and AR follow-up. Identify process gaps and inefficiencies, proposing and driving improvements to optimize revenue recovery. Collaborate with key stakeholders to refine workflows and enhance efficiency in claims resolution. Training & Education: Serve as a subject matter expert (SME) in AR and denial management, providing education to team members as needed. Create and distribute resources on payer-specific denial reasons, appeal processes, and best practices. Provide guidance and support to the team in understanding complex claims and payer rules. Reporting & Analytics: Generate and analyze reports on denials, AR aging, and payer performance to provide insights for leadership. Track key performance indicators (KPIs) related to denials and AR trends, making recommendations for improvements. Present findings and solutions to leadership and stakeholders. Compliance & Policy Adherence: Ensure all denial management and AR follow-up processes align with payer regulations and internal compliance policies. Stay informed on industry regulations and reimbursement changes to mitigate compliance risks. Qualifications & Skills: Experience: Minimum 3-5 years of experience in revenue cycle management, medical billing, or insurance denials resolution. Knowledge: Strong understanding of payer policies, denial management, appeals, and AR workflows. Analytical Skills: Ability to analyze denial trends, identify root causes, and propose effective solutions. Process Improvement: Experience in optimizing workflows and implementing best practices in AR and denials management. Communication: Excellent written and verbal communication skills to collaborate with internal teams and external stakeholders. Technical Skills: Proficiency in revenue cycle systems, electronic health records (EHR), and reporting tools. Compensation for this role between $26.00 to $35.00 per hour. In accordance with Colorado law, the range provided is Radiology Imaging Associate's reasonable estimate of the base compensation for this role, and is based on non-discriminatory factors such as experience, knowledge, skills, and abilities. This position will receive applications on an ongoing basis and will remain open until filled. Radiology Imaging Associates offers a comprehensive benefits package including medical, dental, vision, term life insurance, AD&D, EAP, Short Term Disability, Long Term Disability, PTO and holiday pay for eligible employees. There are also options for voluntary income protection benefits i.e. supplemental life insurance, accident, and critical illness, profit sharing 401(k) retirement plan, and tuition reimbursement. Part-time employees may have access to some of these benefits, which may be on a pro-rated basis. Full-time employees will become eligible for benefits on the first day of the month following 30 days of employment.
RCM AR & Denials Process Lead | Englewood, CO Reports to RCM Manager Employment Type: Full Time Radiology Imaging Associates (RIA) is comprised of over 115 radiologists. All with exceptional skill and expertise, most are fellowship-trained in their field of specialty for additional certification. We are dedicated to accurate and efficient patient diagnosis no matter their condition. Our interventional radiologists perform some of the most leading-edge treatments available today. We partner with primary care physicians and hospitals across Colorado, Nebraska, and Hawaii to provide a resource for both patients and physicians. Position Summary: The AR & Denials Process Lead is responsible for overseeing and optimizing the workflows related to insurance denials, aged accounts, and accounts receivable (AR) follow-up. This role ensures that best practices are implemented to improve revenue collection and reduce denials, while also serving as a subject matter expert and collaborator across teams. This is a process-focused role and does not include direct personnel management. Key Responsibilities: Denial Management & Resolution: Analyze and identify trends in denials and AR delays to develop strategies for reducing avoidable write-offs. Work closely with the billing team, authorization team, and outsourced billing partners to ensure effective and timely follow-up on denied claims. Monitor payer trends and changes in policies to proactively adjust processes and reduce future denials. Process Improvement & Optimization: Develop and implement standard operating procedures (SOPs) for denial management and AR follow-up. Identify process gaps and inefficiencies, proposing and driving improvements to optimize revenue recovery. Collaborate with key stakeholders to refine workflows and enhance efficiency in claims resolution. Training & Education: Serve as a subject matter expert (SME) in AR and denial management, providing education to team members as needed. Create and distribute resources on payer-specific denial reasons, appeal processes, and best practices. Provide guidance and support to the team in understanding complex claims and payer rules. Reporting & Analytics: Generate and analyze reports on denials, AR aging, and payer performance to provide insights for leadership. Track key performance indicators (KPIs) related to denials and AR trends, making recommendations for improvements. Present findings and solutions to leadership and stakeholders. Compliance & Policy Adherence: Ensure all denial management and AR follow-up processes align with payer regulations and internal compliance policies. Stay informed on industry regulations and reimbursement changes to mitigate compliance risks. Qualifications & Skills: Experience: Minimum 3-5 years of experience in revenue cycle management, medical billing, or insurance denials resolution. Knowledge: Strong understanding of payer policies, denial management, appeals, and AR workflows. Analytical Skills: Ability to analyze denial trends, identify root causes, and propose effective solutions. Process Improvement: Experience in optimizing workflows and implementing best practices in AR and denials management. Communication: Excellent written and verbal communication skills to collaborate with internal teams and external stakeholders. Technical Skills: Proficiency in revenue cycle systems, electronic health records (EHR), and reporting tools. Compensation for this role between $26.00 to $35.00 per hour. In accordance with Colorado law, the range provided is Radiology Imaging Associate's reasonable estimate of the base compensation for this role, and is based on non-discriminatory factors such as experience, knowledge, skills, and abilities. This position will receive applications on an ongoing basis and will remain open until filled. Radiology Imaging Associates offers a comprehensive benefits package including medical, dental, vision, term life insurance, AD&D, EAP, Short Term Disability, Long Term Disability, PTO and holiday pay for eligible employees. There are also options for voluntary income protection benefits i.e. supplemental life insurance, accident, and critical illness, profit sharing 401(k) retirement plan, and tuition reimbursement. Part-time employees may have access to some of these benefits, which may be on a pro-rated basis. Full-time employees will become eligible for benefits on the first day of the month following 30 days of employment.