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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare revenue cycle operations, including denial management, appeals, and reimbursement recovery strategies. Proficient in leading teams, managing performance, and implementing process improvements to enhance operational efficiency and compliance.
Highest-signal resume keywords
Healthcare Revenue Cycle OperationsDenial ManagementInsurance Claims ProcessingLeadership ExperienceProcess Improvement
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Denial ManagementAppeals ManagementReimbursement RecoveryInsurance Claims ProcessingMedical BillingFinancial Performance MetricsDenial Trend AnalysisRoot Cause InvestigationRevenue Cycle Management SystemsBilling Platforms
Soft Skills
Effective CommunicationSound JudgmentProject ManagementOrganizational Skills
Tools & Technologies
XIFIN RPMXIFIN Business IntelligenceMicrosoft Office Applications
Industry Keywords
MedicareMedicaidCommercial PayorsHealthcare ComplianceSOPsOperational Controls
About the role
Key responsibilities & impact- Supervise, coach, and support Denial Management Billing Specialists and other assigned staff
- Establish performance expectations, monitor accountability, and address performance outcomes
- Conduct one-on-one meetings, team huddles, coaching sessions, and performance discussions
- Complete performance evaluations and employee development plans
- Participate in recruiting, interviewing, hiring, onboarding, training, cross-training, succession planning, and retention activities
- Assess staffing and capacity requirements, manage schedules, approve time-off requests, and escalate resource risks
- Oversee review, analysis, prioritization, preparation, submission, and follow-up of denied and underpaid insurance claims
- Ensure appeals are accurate, timely, and supported by required documentation
- Serve as primary escalation point for complex claims, coverage, coding, billing, reimbursement, and payor issues
- Monitor productivity, quality, aging, appeal turnaround time, overturn rate, inventory management, and cash collections
- Ensure adherence to payor policies, contractual requirements, SOPs, internal controls, HIPAA, CMS, Medicare, Medicaid, and applicable regulations
- Conduct workflow, documentation, and performance audits
- Implement corrective actions, education plans, and operational controls
- Analyze denial trends and root causes
- Develop denial prevention and reimbursement recovery strategies
- Lead process improvement initiatives to reduce denials, improve appeal success, accelerate reimbursement, and increase cash collections
- Prepare and present performance updates, trends, risks, and recommendations to leadership
- Partner with Billing, Coding, Prior Authorization, Reimbursement, Client Services, Laboratory Operations, Compliance, IT, and payor-facing teams
- Support technology and workflow implementations through requirements gathering, user acceptance testing, change adoption, and post-implementation monitoring
- Develop and maintain SOPs, job aids, escalation processes, and training materials
- Escalate operational, compliance, staffing, payor, and financial risks with mitigation strategies
- Perform additional departmental initiatives and responsibilities as assigned
Requirements
What you’ll need- Associate degree with 3 or more years of experience in healthcare revenue cycle operations; or high school diploma with 5 or more years of experience in healthcare revenue cycle operations
- 5 or more years of experience in healthcare revenue cycle operations, including insurance claims processing, reimbursement, collections, or accounts receivable management
- 3 or more years of experience managing insurance claim denials, appeals, underpayments, and reimbursement recovery activities
- 2 or more years of people leadership experience
- Experience with Medicare, Medicaid, commercial payors, insurance claim adjudication, appeal submissions, and reimbursement workflows
- Experience using revenue cycle management systems, billing platforms, reporting tools, and Microsoft Office applications
- 3 or more years of leadership experience managing healthcare revenue cycle, denial management, appeals, billing, or reimbursement teams
- 3 or more years of experience with medical billing, insurance claims processing, and Explanation of Benefits (EOB) review
- 2 or more years of experience using XIFIN RPM and XIFIN Business Intelligence reporting tools
- 2 or more years of experience supporting reimbursement for genetic, molecular, oncology, or specialty laboratory testing
- Experience supporting Medicare, Medicaid, and commercial payor reimbursement for laboratory testing services
- Experience leading revenue cycle process improvement, system implementations, workflow redesign, or change management programs
- Experience supporting Labcorp Genetics and/or Labcorp Oncology billing and reimbursement operations
- Knowledge of denial management, appeals, payor requirements, reimbursement methodologies, and healthcare revenue cycle practices
- Knowledge of operational and financial performance metrics, denial trend analysis, and root cause investigation techniques
- Effective verbal, written, and presentation communication
- Sound judgment in employee matters, operational risks, compliance concerns, and business decisions
- Project management and organizational skills
- Experience collaborating across operational, clinical, compliance, and technology teams
Benefits
Comp & perks- Medical insurance
- Dental insurance
- Vision insurance
- Life insurance
- Short-term disability (STD) and long-term disability (LTD)
- 401(k) plan
- Paid Time Off (PTO) or Flexible Time Off (FTO)
- Tuition Reimbursement
- Employee Stock Purchase Plan
