Objective :

Develop, maintain, and enforce Standard Operating Procedures (SOPs) to ensure all revenue cycle processes are executed consistently, compliantly, and efficiently—driving operational excellence and aligning team actions with organizational goals.

Key Responsibilities :

SOP Creation & Documentation :

Purpose : Establish clear, step-by-step instructions for all major workflows to minimize errors and ensure process continuity.

Tasks:

  • Create SOPs for all key functions, such as:
  • Patient registration and verification
  • Charge entry and coding
  • Claims submission and remittance posting
  • Denial management and appeals
  • AR follow-up and client reporting
  • Purpose and scope
  • Roles and responsibilities
  • Tools/systems used
  • Detailed process steps
  • Compliance checkpoints
  • Timeframes and escalation paths

SOP Implementation & Training :

Purpose : Ensure all team members understand and follow standardized procedures.

Tasks :

  • Conduct onboarding sessions and refresher training.
  • Integrate SOP reviews into team meetings or QA checks.
  • Provide visual aids (flowcharts, screen captures, templates) to support SOPs.
  • Maintain a centralized SOP library accessible to all staff.

Quality Control & Auditing :

Purpose : Monitor compliance with SOPs and assess their effectiveness.

Tasks :

  • Perform periodic audits or peer reviews to ensure adherence.
  • Identify workflow deviations and their causes.
  • Use SOP compliance data to drive performance improvement.

SOP Maintenance & Continuous Improvement :

Purpose : Keep procedures aligned with changing payer rules, system upgrades, or client requirements.

Tasks :

  • Review and update SOPs regularly (e.g., quarterly or after major changes).
  • Solicit feedback from staff and leadership for process refinement.
  • Version-control all documents and archive outdated protocols.

Our Best Practices:

  • Assign SOP owners by process area for accountability.
  • Use templates for uniform formatting and clarity.
  • Link SOPs with KPIs and quality standards to measure effectiveness.
  • Maintain SOPs in digital, searchable formats (e.g., shared drive, intranet).

Why It’s Important :

SOPs are essential for process consistency, training efficiency, risk reduction, and scalable growth. They align your team, reduce variability, and ensure that every client and patient experience is handled with precision and professionalism.