● Provide financial and operational data analysis to generate insights that advance Departmental, Entity, and system initiatives and improve performance. ● Develop and maintain reports, dashboards, and balance scorecards using visual analytics that provide enhanced insight and improve organizational decision-making. ● Collaborate across revenue cycle operations to develop impactful analysis and messaging to assigned customers. ● Develop personal action plans from meetings and follow through on assigned tasks. ● Identify revenue cycle trends in the data that drive process improvements for revenue cycle, assigned departments, and the system. ● Develop and deliver impactful presentations for senior executives, departmental and/or hospital leaders, and/or at meetings with other key stakeholders. ● Serve as the revenue cycle specialist and liaison for assigned customers, developing solutions to operational and billing functions through collaboration with revenue cycle departments. ● Lead training and education of end users and team members on self-service reporting tools, including preparation of instructional materials and procedural documents. ● Identify and keep abreast of emerging revenue cycle trends, recommending and designing analysis to enhance the enterprise's competitive edge. ● Follow-up and verify quality of work deliverables, prescribed models, responsible for quality review of assigned projects and tasks. ● Perform pre-defined data validation audits and escalate findings outside of standards.

● Audit financial losses (payor denials) for 5 individual hospitals within health system. ● Develop and generate complex financial reports and application programs to retrieve data as requested. ● Ensure accuracy and integrity of analytic reports so that they provide meaningful information for sound business decisions can be made. ● Provide monthly analysis with recommendations to hospital leadership.● Lead projects within the organization. ● Responsible for training new hires on how to read/navigate analytic reports. ● Conduct monthly conference calls to review revenue losses to system.

● Research, analyze and correct initial denial errors and final adjustments from the reporting generated and provided. ● Trend, track and analyze denial reporting patterns and assist in developing and implementing process improvements. ● Recognize information systems, organizational and operational roadblocks that need to be changed to improve the system wide denial experience. ● Create denial tracking mechanism (Excel spreadsheets) of denials and monitor both open and closed denials identified issues. ● Work with multiple departments to resolve initial and final denials on a timely basis ● Train staff to reduce initial and final denials. ● Communicate and work collaboratively with all WellStar Facilities, other Reimbursement/Denials Auditors, Revenue Cycle departments, Medical Management and other Ancillary revenue generating departments. ● Work with sub committees to analyze, support and correct denial and revenue related issues. ● Serve as the key preparer and organizer of Hospital and system wide monthly denial reporting requirements. ● Follow-up denial reasons to a satisfactory conclusion (elimination of the root cause of the denial) and monitor key denial issue findings to make sure the fix is permanent ● Perform complex analytics to resolve initial denials and identify key final denial write off trends for long term corrections. ● Investigate and map complex issues to prepare and solve root causes of denials ● Contacting patients to obtain insurance and demographic information. ● Adding and updating insurance. ● Maintain access to sensitive and confidential patient information/web portals. ● Running and checking patient eligibility.

● Responsible for appealing technical denials to achieve optimal financial outcomes. ● Member of Denials Committee ● Report denial, underpayment and miscellaneous trends to Revenue Cycle VP. ● Prepare and provide updates and suggestions. ● Co-Chairperson of Managed Care Committee ● Discuss and report billing, coding, clinical, front end and care management issues. ● Perform retro reviews of denials and submit formal appeals to payors per contract and department policies. ● Review UB’s in ePremis (Billing System Application) for correct coding.● Create and update tracking spreadsheets to record and analyze trends. ● Report to Managed Care denials manager and business office regarding denial patterns and outcomes of appeals. ● Perform follow-up on appeals, document and track those outcomes. ● Work collaboratively with Managed Care, and Care Management Departments, Business Office, Patient Access and Clinical Denials Specialist. ● Generate itemized bills and reports. ● Verify and analyze payments, recoupments, overpayment and refund requests. ● Authorized to write-off accounts and/or refer outstanding balances to outside venders.