Employer description & source details
Revenue Cycle Performance and Delivery Own end-to-end delivery of Acurus RCM services, including eligibility and benefits verification, prior authorization support, charge entry, medical coding support, claim submission and scrubbing, payment posting (ERA and manual), AR follow-up, denial management, appeals, credit balance resolution, and patient statement support. Deliver against agreed KPIs and SLAs, including net collection rate, days in AR, AR over 90/120 days, clean claim rate, first-pass resolution rate, denial rate by category, posting lag, charge lag, and touch-to-resolution metrics. Drive root-cause analysis on denials and underpayments and translate findings into upstream fixes in partnership with US clinic operations, coding, and credentialing teams. Manage payer-specific complexity across Medicare, Medi-Cal and other Medicaid programs, Medicare Advantage, commercial payers, IPA/MSO capitated arrangements, and workers' compensation. Ensure claims are routed through the most efficient channel (electronic vs. paper), payer mapping is accurate, and clearinghouse rejections are worked promptly. Oversee write-off governance, ensuring adjustments follow approved policy and thresholds and are supported by documentation. Lead the monthly business review (MBR) process with Akido leadership, presenting performance, trends, risks, and improvement plans with clear, data-backed narratives. Run a disciplined operating cadence: daily production huddles, weekly performance reviews, and monthly/quarterly business reviews. Maintain accurate and timely MIS reporting on productivity, quality, inventory aging, and financial outcomes; ensure a single source of truth with the US team. Clearly define and maintain the division of responsibilities between the onshore (US) RCM team an
Extracted skills: excel, security, finance, operations