Paige Dlouhy

Promoted to expand leadership scope across revenue cycle optimization, enterprise process improvement, and inventory management, with continued oversight of Denials & Appeals operations, driving enterprise-wide efficiency, reimbursement performance, and scalable financial outcomes.

• Lead strategic initiatives to optimize end-to-end revenue cycle performance, improving reimbursement, reducing denials, and enhancing cash flow
• Oversee enterprise process improvement efforts, identifying workflow inefficiencies and implementing scalable solutions to increase operational performance
• Manage inventory strategies aligned with billing and reimbursement workflows, improving revenue capture, accuracy, and operational alignment
• Partner with engineering and analytics teams to design and deploy enterprise dashboards, KPI frameworks, and reporting solutions, enabling real-time visibility into productivity, quality, and revenue performance
• Lead cross-functional project initiatives, managing multiple concurrent workstreams focused on denial reduction, inventory optimization, and revenue performance improvement
• Identified operational bottlenecks in inventory and revenue cycle workflows, implementing targeted solutions that reduced delays and improved throughput
• Drive revenue-generating initiatives by increasing denial overturn rates, accelerating appeals resolution, and recovering at-risk revenue
• Analyzed payer behavior, reimbursement trends, and operational data to identify risks and reduce revenue leakage while uncovering optimization opportunities
• Support revenue integrity initiatives by aligning operational processes with payer requirements, coding standards (CPT/ICD-10), and reimbursement policies
• Influence strategic decision-making through data-driven insights and operational performance analysis

Led end-to-end denials and appeals operations within a high-volume insurance billing environment, driving reimbursement optimization and revenue cycle efficiency.

• Oversaw daily revenue cycle workflows including denials resolution, appeals, eligibility verification, billing, and collections processes
• Reduced denial rate by 75% through targeted root-cause analysis and implementation of strategic process improvements
• Increased Average Selling Price (ASP) from $345 to $375+ within 6 months by optimizing payer yield and reimbursement strategies
• Improved team productivity by 80% through implementation of performance dashboards, KPI tracking, and targeted training initiatives
• Optimized reimbursement by analyzing denial trends, payer behavior, and contract performance, reducing A/R aging and improving cash flow
• Executed strategic initiatives to decrease denial rates and enhance collections performance, improving overall revenue cycle efficiency
• Ensured compliance with federal regulations, payer policies, and HIPAA standards
• Managed escalations related to payer disputes, billing discrepancies, and system issues, ensuring timely resolution
• Recognized as a subject matter expert in denials strategy, appeals processes, and revenue cycle optimizationLead and manage end-to-end denials and appeals operations within a high-volume insurance billing environment, ensuring accuracy, compliance, and timely reimbursement.

Oversee daily revenue cycle workflows including denials resolution, appeals submission, eligibility verification, billing, and collections processes.

Drive reimbursement optimization by identifying denial trends, root causes, and implementing payer-specific strategies to reduce A/R aging and improve cash flow.

• Reduced denial rate by 75% through targeted root-cause analysis and strategic process improvements
• Increased Average Selling Price (ASP) from $345 to $375+ within 6 months by optimizing reimbursement strategies and payer yield
• Improved team productivity by 80% through performance dashboards, KPI tracking, and targeted training initiatives

Develop and execute strategic initiatives to decrease denial rates, enhance collections performance, and improve overall revenue cycle efficiency.

Analyze payer behavior, reimbursement patterns, and contract performance to identify risks and opportunities.

Serve as a cross-functional leader across billing, coding, insurance verification, and collections teams to streamline workflows.

Recognized as a subject matter expert in denials strategy, appeals processes, and revenue cycle optimization.

• Developed training programs to enhance staff skills and operational efficiency.
• Collaborated with stakeholders to streamline project timelines and resource allocation.
• Led cross-functional teams to implement process improvements in genetic testing workflows.

• Provided effective direction and guidance to a revenue cycle process redesign project that streamlined workflows and reduced manual intervention, resulting in a 25% decrease in claim rework and a 20% increase in cash collections
• Directed a cross-functional team to integrate a new revenue cycle software, resulting in improved analytical insights into data accuracy and a 10% reduction in billing errors
• Executed targeted improvements following a comprehensive analysis, leading to a notable 15% increase in clean claims submission
• Led teams to meet performance metrics through implementation of advanced training programs on standard operating procedures and transition documents
• Collaborated with C-Suite leaders to develop tailored client solutions that addressed specific needs
• Consistently demonstrate strong organizational skills and attention to detail in facilitating seamless project workflows while Orchestrating meetings and achieving project milestones.

• Achieved a 20% increase in revenue capture and a 15% reduction in denials and rejections
• Conducted root cause analysis on denials and implemented targeted process changes, resulting in a 25% reduction in denied claims and a 15% increase in revenue recovery
• Orchestrated end-to-end denial prevention and management through in-depth analysis of reports, denial trends, and reimbursement policies
• Managed staff through training and mentoring, fostering ownership of development and adherence to standard operating procedures, resulting in 30% decrease in training time and improved billing and coding accuracy
• Assessed and reported complex data and projects to internal and external stakeholders, emphasizing risk control and clear communication of loss exposures
• Partnered with project managers to provide data analysis support and ensure successful project deliverables
• Communicated updates transparently, facilitating understanding among project participants and delivering regular status reports to stakeholders
• Facilitating a cohesive understanding among project participants and delivering regular status reports to all stakeholders.