Manage day-to-day revenue cycle operations for lab services including denials management, appeals, self-pay inventory, claims write-offs, client edits, payer policy changes, AR aging, eligibility and insurance discovery. Oversee and report denials/appeals activity, guide team to meet AR and collection goals, identify payment trends and process improvements, ensure regulatory and policy compliance, and support recruitment, training and workload allocation.
Pacific Diagnostic Laboratories seeks a PDL Revenue Operations Analyst for their Administration department responsible for the overall day-to-day operations of denials management, appeals, self-pay inventory, claims write-offs, client edits, client portal usage, payer policy changes, AR aging across all payer classes, insurance eligibility and insurance discovery trends. Actively oversees, maintains, and communicates denials and appeals activity to clients and internal stakeholders. Provides guidance and direction to the team to ensure the department maintains or exceeds goals including total AR collections, credit balances, # of and amount of edits and denials, identifies emerging trends in claims payments and assesses expected vs actual reimbursement. Ensures all activities are performed in compliance with Cottage Health (CH) and PDL policies, procedures, and Federal and State regulations. Assists in recruitment, retention, training and work allocation.
QUALIFICATIONS:
All job qualifications listed indicate the minimum level necessary to perform this job proficiently.
Education:
- Required: Bachelor's degree or equivalent Lab RCM work experience of 6 years.
Technical Requirements:
- Required: Must be able to demonstrate an understanding of ICD-10 coding for Lab CPT's, working payer denials and appeal processes. Expertise in healthcare insurance eligibility, verification and claims filing procedures. Expertise in utilizing software applications to maximize automation and efficiency in a business office setting. Proficient in Microsoft Office suite, with an emphasis on Excel and PowerPoint. Able to analyze data to identify trends and opportunities for process improvement.
- Preferred: MS-Office 365.
Years of Related Work Experience:
- Required: Five years LAB RCM experience, preferably in a multi-facility environment including three (3) years of progressive responsibility in healthcare revenue cycle. Experience working with legal consent policy and procedures and payer contracting and policies. Knowledge of medical terminology.
- Preferred: Minimum if five (5) years related work experience.
Cottage Health is a leading acute care hospital system, located on the central coast of California, widely known for our superior patient care, innovation, medical research and education. Our health system operates primarily in Santa Barbara, CA, since 1888, and consists of three acute care hospitals, a Rehabilitation Hospital, multiple clinics and a multi-site Urgent Care system. Our mission is to serve the central coast communities with excellence, integrity, and compassion. Every day we touch thousands of lives in many different ways, resolute in our mission to put patients first. We take pride in helping our patients get back to living their lives - in the places they love.
*Pay for non-physician positions is determined based on related years of experience and internal equity. Eligible employees may also receive additional forms of compensation, including shift differentials, on-call pay, incentive pay, and bonus opportunities, where applicable. Manager and above positions may participate in Cottage Health’s annual management incentive program. Physician compensation is determined based upon specialty and may include bonus potential. For more information on our comprehensive Total Rewards offerings, please visit https://cottagehealth.org/careers/total-rewards.
If you're already a Cottage Health employee, please apply on this link only.
Similar Jobs
Artificial Intelligence • Automotive • Greentech • Information Technology • Machine Learning • Software • Cybersecurity
Owns relationships and retention for a regional portfolio of automotive dealership clients. Drives product adoption, analyzes account performance, addresses at-risk relationships, identifies upsell opportunities, communicates client needs internally, and improves client processes. The role requires onsite and virtual engagements, product knowledge, independent work, and travel of up to 50% across Colorado, Arizona, Utah, and New Mexico.
Top Skills:
Microsoft SuiteScreen Sharing TechnologiesWeb-Based Systems
Artificial Intelligence • Automotive • Greentech • Information Technology • Machine Learning • Software • Cybersecurity
Manages a regional portfolio of automotive dealership clients, focusing on retention, product utilization, relationship development, risk mitigation, and revenue expansion. Acts as the client advocate, identifies business problems, develops action plans for at-risk accounts, analyzes performance trends, promotes product enhancements, and upsells additional functionality. The role requires onsite and virtual client engagement, autonomous remote work, collaboration across departments, and travel of up to 50%.
Top Skills:
Microsoft SuiteScreen Sharing TechnologiesVinsolutionsWeb-Based Systems
Artificial Intelligence • Automotive • Greentech • Information Technology • Machine Learning • Software • Cybersecurity
Manages a regional portfolio of automotive dealership clients, driving retention, product utilization, client satisfaction, and revenue growth. Builds client relationships, identifies risks, develops retention plans, supports product adoption, analyzes account performance, and upsells additional functionality. The role requires onsite and virtual client engagement, collaboration across departments, automotive dealership expertise, remote autonomy, and travel of up to 50% across Colorado, Arizona, Utah, and New Mexico.
Top Skills:
Microsoft SuiteScreen-Sharing TechnologiesVinsolutionsWeb-Based Systems
What you need to know about the Austin Tech Scene
Austin has a diverse and thriving tech ecosystem thanks to home-grown companies like Dell and major campuses for IBM, AMD and Apple. The state’s flagship university, the University of Texas at Austin, is known for its engineering school, and the city is known for its annual South by Southwest tech and media conference. Austin’s tech scene spans many verticals, but it’s particularly known for hardware, including semiconductors, as well as AI, biotechnology and cloud computing. And its food and music scene, low taxes and favorable climate has made the city a destination for tech workers from across the country.
Key Facts About Austin Tech
- Number of Tech Workers: 180,500; 13.7% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Dell, IBM, AMD, Apple, Alphabet
- Key Industries: Artificial intelligence, hardware, cloud computing, software, healthtech
- Funding Landscape: $4.5 billion in VC funding in 2024 (Pitchbook)
- Notable Investors: Live Oak Ventures, Austin Ventures, Hinge Capital, Gigafund, KdT Ventures, Next Coast Ventures, Silverton Partners
- Research Centers and Universities: University of Texas, Southwestern University, Texas State University, Center for Complex Quantum Systems, Oden Institute for Computational Engineering and Sciences, Texas Advanced Computing Center
