RCM manager
Where should I intervene to unblock teams?
Next-best action:
Rebalance denials queue by re-allocating 15 Aetna denials to Specialist Ortiz.
Revenue at Risk
$1,250,000
Unassigned Queues
9 tasks
Team Throughput
84 outcomes/day
| Priority |
ID |
Payer |
Specialty/Client |
Type |
Exposure |
Age |
Owner |
Status |
Evidence |
Next-Best Action |
Actions |
| urgent |
WO-TASK-ASC-CASE-008-missing_payer_response |
Acc |
ASC Orthopedics |
AR Follow-Up |
$76,400.00 |
21 days |
Maya Foster |
Human Action Required |
3 files |
Biller should validate clearing status and prepare a payer follow-up checklist for human review. |
Open |
| urgent |
WO-TASK-ASC-CASE-008-stale_followup |
Acc |
ASC Orthopedics |
AR Follow-Up |
$76,400.00 |
21 days |
Maya Foster |
Human Action Required |
3 files |
Assigned owner should validate follow-up history and refresh the next action plan for human review. |
Open |
| high |
WO-TASK-ASC-CASE-007-stale_followup |
Acc |
ASC Orthopedics |
AR Follow-Up |
$400.00 |
21 days |
Maya Foster |
Human Action Required |
3 files |
Assigned owner should validate follow-up history and refresh the next action plan for human review. |
Open |
| high |
WO-TASK-ASC-CASE-007-underpayment |
Acc |
ASC Orthopedics |
Underpayment |
$400.00 |
21 days |
Maya Foster |
Human Action Required |
3 files |
Underpayment specialist or biller should validate contract terms, payment variance, and follow-up path for human review. |
Open |