Revenue Cycle Department Transformation for Operational Efficiency

Case Study.

Project Overview

Market: Ambulatory Care
Primary Service: Practice Management

John Lynch & Associates partnered with a healthcare organization undergoing a strategic evaluation of its Revenue Cycle Management (RCM) department. The client sought expert guidance to assess current inefficiencies, prioritize corrective actions, and implement sustainable improvements. Our team delivered a comprehensive transformation plan and provided hands-on leadership throughout the initiative.

Objectives

  • Evaluate the current state of the Revenue Cycle Department.
  • Identify and prioritize projects to address inefficiencies and backlogs.
  • Implement actionable plans to resolve operational gaps.
  • Train new resources and leadership on RCM best practices.
  • Ensure continuity through documentation and leadership transition.

Challenges

  • Lack of clear project prioritization and visibility into unresolved claims and billing work.
  • Operational inefficiencies and system-based errors affecting RCM throughput.
  • Need for experienced leadership and structured project implementation.
  • Gaps in training and documentation for new staff and leadership roles.

Solutions Implemented

To overcome these challenges, the following solutions were implemented:
  • Conducted a detailed analysis of current RCM operations.
  • Identified 25 critical projects to improve department performance, addressing both internal deficiencies and outstanding claims work.
  • Delivered a prioritized roadmap with action plans for each project.
  • Supplied system reports with detailed guidance, corrective recommendations, and next steps.
  • Designed and implemented role-specific training for new RCM team members.
  • Established a reporting framework to provide daily, weekly, and monthly updates to executive leadership.
  • Created customized job aides for the Revenue Cycle Manager, covering key operational areas such as:
    • Adjustments Batch Posting
    • CO16 Denials Processing
    • Claims Submission & Production
    • Unbilled Reporting
    • Tasking Analysis
    • RCM Throughput Reports
    • System-specific functions like the Background Business Processor
  • Supported the client in screening and onboarding a new Director of Revenue Cycle.
  • Transitioned all active projects and documentation to internal leadership for ongoing management.

Results

  • Delivered a fully structured, prioritized transformation plan with measurable progress tracking.
  • Strengthened operational reporting and accountability at all levels of the RCM department.
  • Successfully transitioned project ownership to a newly hired Director of Revenue Cycle.
  • Enhanced team readiness through targeted training and comprehensive job aides.
  • Positioned the organization for long-term success with sustainable process improvements.

Conclusion

By applying deep industry expertise and structured project leadership, John Lynch & Associates helped this healthcare organization transform its Revenue Cycle Department into a more efficient and accountable operation. Through a strategic approach and hands-on support, we ensured lasting improvements aligned with the organization’s goals.

Client Feedback

“John Lynch & Associates brought clarity and direction during a pivotal time in our Revenue Cycle transformation. Their ability to assess, organize, and execute across multiple priorities helped us regain control of our operations and prepare our internal team for future success.”
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