Revenue Strategy Associate
About the role
Detail-driven Revenue Strategy Associate at Verse Medical, joining the revenue cycle team to analyze denials, identify root causes, and drive remediation and revenue recovery through collaboration with payers, coders, and product/engineering.
Responsibilities
- Analyze denial patterns across payers, HCPCS codes, and product lines to identify systemic root causes to aid in the development of actionable remediation strategies.
- Conduct direct payer outreach, calling insurance representatives, and escalating cases to discover the root cause of denials and underpaid claims.
- Build and maintain denial, issue, and project tracking dashboards and reporting packages that give leadership a clear view of denials, causes, and the ongoing work to fix the denials.
- Develop methodologies in coordination with the head of RCM for denial prioritization.
- Perform root cause analysis on high-volume and high-dollar denials, documenting findings and presenting recommendations.
- Partner with coders, billers, and front-end staff to share insights and reduce revenue leakage through upstream gaps contributing to recurring denials (eligibility, auth, coding, documentation).
- Monitor payer policy changes and updates, flagging impacts to current billing practices and advising on workflow adjustments.
- Collaborate with product and engineering to provide detailed insights into the root cause of denials and assist in crafting solutions.
Qualifications
- 3–6 years in RCM, with at least 1–2 years in a consulting or advisory capacity.
- Demonstrated experience working denials across commercial, Medicare, and Medicaid payers.
- Track record of calling payers directly, navigating payer portals, and managing the appeals lifecycle end-to-end.
Skills
Benefits
- Competitive benefits
- Professional development opportunities
- Culture prioritizes work-life balance and continuous improvement.
About Verse Medical
Software platform for in-home healthcare
As healthcare costs have increased, the patient's home has become incredibly important as a site of care. Yet, patients recovering at home are highly underserved. Patients can only get better at home if they receive the high-quality care that they need reliably. The existing in-home care process involves patchwork of different vendors, all connected through faxes by nurses. We're building modern, robust software that solves this challenge and brings this market online.
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