Direct and manage AR follow-up activities across all payer types, including: Workers’ Compensation (fee schedules, direct bill, employer/carrier models), Commercial insurance, Medicare.
Establish AR prioritization strategies by payer, aging bucket, service line, and dollar value.
Monitor and drive performance for current AR, 31-60, 61-90, 91-180, and 181+ day buckets.
Manage the resolution of holds, missing information, and errors related to claim submission.
Partner with finance to support monthly AR reconciliation, variance analysis, and cash forecasting.
Provide direct oversight of WC AR and staff.
Manage litigation-related AR.
Oversee lien preparation, submission, tracking, and resolution.
Lead denial prevention strategies across all payers.
Oversee denial management workflows.
Manage appeals and reconsiderations for: Medicare, Commercial payers, Workers’ Compensation disputes.
Assumes other responsibilities as appropriate to the position and organizational needs.

5+ years of progressive experience in healthcare revenue cycle management, with direct AR and denial management leadership experience.
Strong Workers’ Compensation billing expertise, including litigation and lien resolution.
Hands-on experience managing Commercial and Medicare AR and appeals.
Demonstrated success in denial prevention and root cause analysis.
Experience leading teams in high-volume, multi-payer environment.
Strong analytical, organizational, and communication skills.
Experience building and managing AR and denial dashboards, reporting tools, and billing platforms.
Experience with multiple EHR/Practice Management systems (IMS, Nextgen, Athena, eClinicalWorks or similar).
Accuracy and attention to detail, analytical thinking and problem solving and high integrity and compliance focus.
Advanced proficiency in Microsoft Excel (e.g., formulas, pivot tables) and solid skills in other Microsoft Office applications.

AR & Denial Prevention Manager

Key skills