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
Financial Services
Develops data mining, analytics, reporting, AI tools, and scalable cloud applications for finance. Aggregates data, improves data infrastructure and processing workflows, ensures data integrity, and partners with finance and MIS teams on reporting and strategic insights. Leads MIS initiatives, supports model development and deployment, provides technical guidance, and recommends performance improvements based on financial trends.
Top Skills:
AWSAzureBig Data TechnologiesCi/CdData WarehousingDatabricksDevOpsETLGCPJavaMachine LearningPythonScalaSQLTableauThoughtspot
Cloud • Fintech • Food • Information Technology • Software • Hospitality
Design intuitive payroll and team-management experiences for web and mobile applications. Collaborate with designers, product managers, and engineers to deliver polished, accessible interfaces for onboarding, payroll preparation, labor review, reporting, compliance, and payment workflows. Apply design systems, incorporate customer feedback, leverage AI tools thoughtfully, prototype rapidly, and produce pixel-perfect designs for development handoff.
Top Skills:
ClaudeFigmaFigma MakeMagic PatternsReplitV0
Automotive • Greentech • HR Tech • Sales • Software
Designs and develops interactive online training, microcontent, simulations, and promotional videos focused on technical and compliance topics. Collaborates with subject matter experts and cross-functional stakeholders to create engaging learning experiences using adult learning principles and eLearning authoring tools. Supports multimedia editing, manages multiple projects and deadlines, incorporates feedback, and assists with training team documentation and administrative tasks.
Top Skills:
Articulate 360RiseScormStorylineXapi
What you need to know about the NYC Tech Scene
As the undisputed financial capital of the world, New York City is an epicenter of startup funding activity. The city has a thriving fintech scene and is a major player in verticals ranging from AI to biotech, cybersecurity and digital media. It also has universities like NYU, Columbia and Cornell Tech attracting students and researchers from across the globe, providing the ecosystem with a constant influx of world-class talent. And its East Coast location and three international airports make it a perfect spot for European companies establishing a foothold in the United States.
Key Facts About NYC Tech
- Number of Tech Workers: 549,200; 6% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Capgemini, Bloomberg, IBM, Spotify
- Key Industries: Artificial intelligence, Fintech
- Funding Landscape: $25.5 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Greycroft, Thrive Capital, Union Square Ventures, FirstMark Capital, Tiger Global Management, Tribeca Venture Partners, Insight Partners, Two Sigma Ventures
- Research Centers and Universities: Columbia University, New York University, Fordham University, CUNY, AI Now Institute, Flatiron Institute, C.N. Yang Institute for Theoretical Physics, NASA Space Radiation Laboratory
