Responsible for contract SLA, production monitoring and quality audit completion of all revenue cycle processes performed by international vendors. Oversee and collaborative work global leadership, vendor leadership, and Operations team. Ensure the vendors’ performance, address any deficiencies, and provide appropriate process remediation.

Provide support for all quality reviews and assessments of revenue cycle processes by international vendors. Assist in ensuring vendors adhere to process and procedure according to vendor agreement. Trend and research volume sent back to SSCs by way of vendor escalations/returns. Educate and train new team members on vendor quality processes. Daily collaborate with Global Operations Manager and Strategic Resource Team to define vendor processes.

Coached team members in techniques necessary to complete job tasks.Trained new team members by relaying information on company procedures and safety requirements.Evaluated employee skills and knowledge regularly, training, and mentoring individuals with lagging skills.Established open and professional relationships with team members to achieve quick resolutions for various issues.Took on additional job duties during unexpected backlog, resulting in meeting project target date.Prepared detailed reports on updates to project specifications, progress, identified conflicts and team activities.

Review post discharge, prebill accounts that do not have an authorization on file, ALOS versus days authorized variances, and/or other account discrepancies identified that will result in the account being denied by the payor that do not require a clinical review.Communicates with third party payors to resolve discrepancies prior to billing.Accurately and concisely documents all communications and action taken on the account in accordance with policies and procedures.The Prebill Denials Analyst will escalate medical review request and/or denial activities to the Prebill Denials Nurse.Work prebill accounts imported into the PDU Tool efficiently and effectively on a daily basis to resolve accounts with “no auth numbers and ALOS vs.Authorized days variancesWork assigned accounts in eRequest to resolve outstanding issuesReport insurance denial trends identified during daily operational assignmentsIdentify problem accounts and escalate as appropriateDocument actions taken on the account clearly and conciselyContacting the facilities, physicians’ offices and/or insurance companies to resolve denials/appeals