Note: The job is a remote job and is open to candidates in USA. Baptist Health is the largest healthcare system serving central Alabama, providing comprehensive hospital-based and outpatient services. The Manager, Revenue Cycle Optimization and Education will oversee quality and training functions for Patient Access denial prevention, design audit programs, and drive performance improvement initiatives to enhance revenue integrity.
Responsibilities
- Oversee all front‑end technical denials associated with Patient Access workflows, including registration accuracy, eligibility verification, prior authorization, medical necessity validation, and service order completeness
- Partners closely with Patient Access leadership and the Patient Access System Director to implement corrective actions, redesign workflows, and establish clear accountability mechanisms that support denial prevention
- Conducts comprehensive root‑cause analysis on technical denials and develops targeted, sustainable action plans to prevent recurrence
- Designs, leads, and maintains the Patient Access Quality Review Program with a strong focus on reducing preventable denials and improving front‑end accuracy
- Performs routine and targeted audits of Patient Access functions, identifying compliance issues, accuracy gaps, and training needs that impact revenue integrity
- Develops high‑quality reports and dashboards for the Patient Access System Director and revenue cycle leadership, providing actionable insights and performance trends
- Creates and deploys targeted ad‑hoc training based on real‑time denial trends, audit findings, and operational needs
- Develops and maintains annual refresher training for Patient Access and related departments, ensuring ongoing competency and alignment with organizational standards
- Designs and oversees new‑hire onboarding and competency‑based training programs focused on denial prevention, workflow accuracy, and regulatory compliance
- Collaborates with system education departments to ensure training content aligns with Baptist Health standards, payer requirements, and regulatory updates
- Supports systemwide denial mitigation strategies in partnership with the Patient Access System Director, contributing to organizational revenue integrity goals
- Leads, coaches, and mentors staff, establishing clear performance expectations and ensuring consistent execution of denial prevention workflows
- Prepare regular denial trend reports, performance summaries, and recommendations for process improvement
- Serves as a system‑level subject matter expert in denial prevention, Patient Access accuracy, payer requirements, and training methodology
- Participates in cross‑functional committees, revenue cycle task forces, and performance improvement initiatives to advance systemwide operational excellence
Skills
- Degree required in Business Administration, Healthcare Administration, Finance, Education or other related fields that support operational, analytical, or instructional responsibilities
- Minimum 10 years' experience within healthcare revenue cycle, with at least 7 years dedicated to Patient Access operations across technical workflows such as registration, insurance verification, prior authorization, financial clearance, and front-end denial prevention
- Demonstrated expertise in analyzing, trending, and resolving technical denials, including the ability to identify root causes and implement sustainable corrective actions
- Experience developing and delivering training programs, competency assessments, audit tools, and performance improvement initiatives that support operational accuracy and compliance
- Active Certified Healthcare Access Manager (CHAM), or Certified Healthcare Access Associate (CHAA), or Certified Revenue Cycle Specialist (CRCS) required or obtained within 1 year of hire
- Bachelor's degree preferred
- Advanced training or coursework in revenue cycle management, healthcare operations, instructional design, quality improvement, or payer compliance is strongly preferred
- Leadership or management experience strongly preferred, including oversight of teams, coaching, workflow development, and cross‑functional project leadership
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