Denial Management System
Dashboard with denial reason tracking, automated follow-up queues at 7 and 14 days, payer-specific appeal workflows, and denial trend reporting by CPT code and provider.
Your revenuedoesn't have a billingproblem.It has asystems problem.
I build the automation layer between your billing, coding, credentialing, and collections — so your team manages exceptions, not volume.
Most practices I speak with have at least one area quietly draining time or revenue. Sometimes it's denial rates creeping up because claims are going out with coding errors nobody caught. Sometimes it's credentialing — a provider sitting in payer enrollment limbo for six weeks while the practice can't bill for their work. Sometimes it's AR: the follow-up queue is a spreadsheet, the 7-day and 14-day touchpoints depend on someone remembering, and the aging report is a number nobody fully trusts.
None of it is catastrophic alone. Together it compounds. And the fix is rarely more staff — it's a system that handles volume so staff can handle complexity.
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What I build
Credentialing Tracker
Provider enrollment status by payer, re-credentialing calendar alerts, CAQH update reminders, and a dashboard showing which providers are billable and which are pending.
AR Aging Automation
Automated follow-up triggers on outstanding claims, patient balance notifications, payer-specific AR rules, and aging dashboards showing exactly where your 60+ day buckets are building.
Coding Workflow & QA
Pre-submission claim review layer, coding error flags before clearinghouse submission, modifier audit trails, and integration with your existing EHR or PM system.
RCM Reporting Dashboard
Real-time view of collection rates by payer, denial rates by provider and code, days in AR, and net collection rate — all in one place without exporting to Excel.
EHR & PMS Integrations
API integrations with eClinicalWorks, athenahealth, Kareo, AdvancedMD, and major clearinghouses. Your existing systems stay; I add the automation layer on top.
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RAC & audit response
/ Recovery Audit Contractor workflowsRecovery Audit Contractor (RAC) activity and payer audits don't fail because your team lacks effort — they fail because deadlines, documentation requests, and appeal packets live in email threads and shared drives. I build the intake and response layer so nothing expires quietly.
RAC audit intake & triage
Centralise Recovery Audit Contractor (RAC) letters and demand letters — classify by payer, deadline, dollar at risk, and route to the right billing lead before the clock runs out.
Medical record request queues
Track which charts were pulled, which are pending, and which are overdue — with automated reminders at 7, 14, and 30 days so documentation doesn't become a write-off.
Appeal & rebuttal workflows
Structured appeal paths with templates, supporting-doc checklists, and status tracking from first-level review through ALJ — so your team isn't rebuilding the packet from scratch every time.
RAC trend reporting
See which CPT codes, providers, and payers are generating the most audit activity — spot patterns before they become a revenue line item.
Right for you if…
- You're a practice manager, billing director, or ops lead at a medical practice, clinic, or MSO
- Your denial rate is above 8% or your AR days are above 40 — and manual follow-up isn't moving the number
- You have a multi-provider or multi-location operation that doesn't scale with headcount
- You know the problem is in the workflow, not the staff, and you need a developer who understands both
- You want automation that your team can operate — not a black box that requires a consultant every time something changes
- You're getting RAC or payer audit activity and need a system — not another spreadsheet — to manage response deadlines
03 —
Adjacent proof
I haven't published a healthcare case study yet — I'm building toward that with my first engagements. What I have: CRM pipelines with claim-like status tracking and retry logic, role-based access systems that mirror HIPAA minimum-necessary requirements, automated AR follow-up queues from other industries, multi-entity platforms where financial data stays properly separated. The systems are the same. The domain is new.
First healthcare engagement: referral-rate pricing and a published case study in return.
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Contact
Got a revenue cycle problem worth solving?
Tell me where the leak is — billing, coding, credentialing, AR, or somewhere in between. I'll tell you if I'm the right fit.
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