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Client Ownership & Performance Accountability
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Serve as the single accountable owner for full client setup and ongoing RCM performance across all sites. Ensure workflows, automations, authorizations, reporting, and system configurations are aligned prior to and after go-live. - Actively monitor AR aging, denials, authorization timeliness, claim submission lag, payer trends, utilization, and workflow metrics. Identify risks before they impact cash flow or client experience and take structured action to correct them. - Lead root cause analyses when performance gaps emerge and implement operational, workflow, or system-level solutions that produce measurable improvements. - Drive accountability internally and facilitate direct performance conversations with client owners when necessary. Manage escalations with clarity and confidence. - Front of House Operations Oversight
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Oversee and ensure consistent execution of front-of-house revenue cycle processes across all supported clients and teams. - Ensure clients maintain 100% payer enrollment completion, both initially and through ongoing quarterly reviews to maintain active electronic billing capabilities. - Oversee payer configuration to ensure electronic claim submission is utilized whenever possible, and that automatic paper claim mailing is configured when electronic submission is unavailable. - Establish and enforce a standardized EOB upload policy across teams to ensure timely and accurate documentation of payer responses. - Ensure front office teams collect and document accurate patient insurance benefit information, including coverage details, copays, coinsurance, and deductibles, using standardized policy note documentation. - Drive standardized upfront collections processes
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Ensure operational adherence to patient accounts receivable policies
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Ensure insurance card images are uploaded and patient intake documentation is completed accurately prior to or at the time of service. - Oversee payer setup to ensure authorization requirements are configured correctly and aligned with payer rules. - Ensure authorizations are managed daily according to established standards, including monitoring and rescheduling visits when authorization requirements are not met. - Oversee payer configuration and workflow setup to enable RCM automation and operational efficiency across the Prompt RCM team. - Monitor clinical coding optimization efforts, coaching teams on coding accuracy and ensuring billing aligns with visit duration and documentation standards
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Implement and monitor reporting processes to identify visits without claims, ensuring providers complete documentation and front office teams properly check in visits. - Analytics, BI & System Optimization
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Own performance reporting and visibility across accounts. Build and maintain dashboards, KPI frameworks, forecasting models, and predictive indicators that strengthen leadership insight and operational precision. - Configure sites and BI environments to maximize automation, reporting accuracy, and workflow efficiency. Ensure each client’s reporting structure supports operational execution and financial clarity. - Serve as a Prompt product expert and primary interface between RCM, Enterprise clients, BI, and Product teams. - Translate operational and enterprise feedback into actionable feature requests and ensure system capabilities are fully leveraged to reduce manual work and improve scalability. Minimum Requirements
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Bachelor’s Degree in Business, Analytics, Healthcare Administration, Finance, or related field. - 7+ years of experience in revenue cycle operations, healthcare analytics, or performance leadership. - Strong working knowledge of claims management, denials, authorizations, AR aging, payer behavior, and workflow optimization. - Demonstrated experience building and configuring Business Intelligence (BI) dashboards and reporting environments. - Experience implementing operational change across multiple sites or enterprise-level healthcare clients. - Proven ability to manage escalations and conduct performance-driven conversations with owners or executive stakeholders. - Advanced analytical skills with the ability to translate data into structured operational action. - Ability to operate independently with high accountability and cross-functional influence. The specific statements provided in this job description are not exhaustive and may be subject to change based on evolving business needs. Associates may be required to perform additional duties as assigned.
