Your future role at a glanceLocation: Remote
Department: Revenue Cycle Administration
Schedule: Full-Time, Day
Salary: $99,863.85 - $135,109.91
Eligible for an annual bonus incentive
#LI-Remote
#InternalOp
How you'll make an impact in this role- Strategic JOC Operations & Governance: Facilitate and document 45 monthly Joint Operating Committee (JOC) executive sessions with key commercial and government payers, maintaining partnership agreements, translating revised contract provisions/policies into operational workflows, and delivering concise yield and performance outcome reporting to executive leadership.
- Complex Denial Mitigation & High-Dollar Escalations: Act as the primary escalation lead and senior negotiator for complex, high-dollar claim disputes and denials across five multi-state regions, deploying advanced revenue integrity tactics to drive rapid variance resolution and maximum reimbursement.
- Log Architecture & Inventory Management: Direct the continuous auditing, triage, and monthly transmission of six specialized escalation logs, overseeing vendor communication streams (including R1 RCM) to ensure systematic inventory clearance and high-dollar account compliance with Ascension revenue standards.
- Team Supervision & Technical Mentorship: Direct and develop Senior Analysts by establishing rigorous review standards for claim denial inquiries, setting escalation documentation criteria, and managing daily task allocation across competing regional priorities.
- Payer Intelligence & Portfolio Analytics: Conduct structured monthly reviews on aged inventory using advanced analytics tools to identify root-cause denial trends, leverage payer portal platforms, and monitor payer policy shifts across major national accounts.
What minimum requirements you'll needLicensure / Certification / Registration:
- Certified Coding Specialist (CCS) credentialed from the American Health Information Management Association (AHIMA) preferred. Licensure required relevant to state in which work is performed.
Education:
- High School diploma equivalency with 3 years of cumulative experience OR Associate's degree/Bachelor's degree with 2 years of cumulative experience OR 7 years of applicable cumulative job specific experience required.
- 3 years of leadership or management experience preferred.
What additional preferences we're seeking- Advanced professional revenue cycle certification (e.g., CRCR, CSPR, or CSPPM).
- Direct experience structuring and facilitating JOC or strategic payer-provider alignment frameworks.
- Deep subject-matter expertise with major national and regional payer environments (e.g., UHC, BCBS, Cigna, Aetna, Humana) and vendor ecosystem integrations (e.g., R1 RCM).
Responsibilities- Strategic JOC Operations & Governance: Facilitate and document ~45 monthly Joint Operating Committee (JOC) executive sessions with key commercial and government payers, maintaining partnership agreements, translating revised contract provisions and policies into operational workflows does not apply to this role. The manager's responsibility is limited to sharing policy updates received during JOC meetings with the appropriate parties .
- Complex Denial Mitigation & High-Dollar Escalations: Act as the primary escalation lead and senior negotiator for complex, high-dollar claim disputes and denials across five multi-state regions, deploying advanced revenue integrity tactics to drive rapid variance resolution and maximum reimbursement.
- Log Architecture & Inventory Management: Direct the continuous auditing, triage, and monthly transmission of six specialized escalation logs, overseeing vendor communication streams (including R1 RCM) to ensure systematic inventory clearance and high-dollar account compliance with Ascension revenue standards.
- Team Supervision & Technical Mentorship: Direct and develop Senior Analysts by establishing rigorous review standards for claim denial inquiries, setting escalation documentation criteria, and managing daily task allocation across competing regional priorities.
- Payer Intelligence & Portfolio Analytics: Conduct structured monthly reviews on aged inventory (outstanding inventory escalated and discussed at the JOC meetings) to determine if items need to be sent to Legal or to the vendor R1 for next steps, while maintaining awareness of payer policy updates and contract provisions.
QualificationsLicensure / Certification / Registration:
- Certified Coding Specialist (CCS) credentialed from the American Health Information Management Association (AHIMA) preferred. Licensure required relevant to state in which work is performed.
Education:
- High School diploma equivalency with 3 years of cumulative experience OR Associate's degree/Bachelor's degree with 2 years of cumulative experience OR 7 years of applicable cumulative job specific experience required.
- 3 years of leadership or management experience preferred.
