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director of revenue reimbursement resume example with 19+ years of experience

Jessica
Claire
resumesample@example.com
(555) 432-1000,
, , 100 Montgomery St. 10th Floor
:
Professional Summary

Over 13 years of leading complex team project collaborations while driving strategic goals through implementation of decision support analytics, and defining specialty based reporting to engage continuous and measurable revenue cycle and case profitability in the healthcare arena. Process improvement leadership while maintaining a critical focus on fostering, balancing, and leveraging the needs of multidisciplinary groups to increase volume and sustain overall fiscal health of the facility. Well-qualified financial systems leader successful in managing internal accounting processes, improving controls, accounting, budget administration and forecasting. Gifted in building and retaining solid teams to handle high-volume operations with consistency and accuracy.

Highlights
  • Revenue Cycle Management
  • Performance Optimization Strategies
  • Appeals/ Denial Management
  • Margin Preservation Excellence
  • Payor Strategy/ Plan Management Operations Liaison
  • Productivity Specialist
  • Operational & Service Line P&L Maximization
  • Physician Relocation & Credentialing
  • Interdisciplinary Process Improvement Champion
  • Project Management
Education
University of South Carolina - Columbia Columbia, SC Expected in 2018 Masters Certificate : Public Health - GPA :
Embry-Riddle Aeronautical University, University Daytona Beach, FL, Expected in 2016 Master of Science : Leadership - GPA :
University of Florida Gainesville, FL Expected in 2012 Bachelor of Science : Business Administration - GPA :
Work History
Alterra Mountain Co - Director of Revenue & Reimbursement
Winter Park, CO, 05/2014 - Current
  • Revenue Cycle Management for $1.4B, 5-Star Rated Acute Care Facility, within second largest private healthcare provider in US
  • Reduced overall AR Days from 67.0 to 51.5; created expedited cash payments through targeted enterprise-wide analysis and collection projects with AR Vendor Management partnerships
  • Increased margin from 22% to 26% and reduced overall facility controllable denial reductions by over $125k per quarter by working within core teams to streamline business processes and internal controls
  • COVID Operational Surg Planning Leader; created emergent operational workflows to ensure minimal fiscal health interruption during pandemic; created Telehealth availability for clinical and ancillary departments, created additional surge overflow bed availability, interim billing cycles for long-term care patients, as well as case mix report reviews to ensure new COVID billing requirements met for supplemental payment opportunities
  • Created trending service line gains/deterioration reporting and evaluations based on physician and community referral patterns; ensured and maintained Managed Care contracting is consistent with market trends and needs to reduce overall bad debt impacts and minimize payor denials while safeguarding reimbursements and mitigating denial write-offs to less than 1.1% ANPR
Infoblox Inc. - Accounting Manager
Denver, CO, 06/2009 - 05/2014
  • Developed and trained clinical staff on reporting requirements, charge and revenue capture, Midnight Census, volume, cost, revenue, budget performance, productivity, core staff requirements; district wide implementation of training methods and materials implemented at regional level due to facility success with core audit measures and financial impact trending reports resulting in 5-star performance in monthly audits
  • Prepared Medicare Cost Report, Quarterly Disclosure report, CER’s, TCHI report, Annual CON report (NICU), AHCA report, Health Care District contractual funding (HCD), LIP, Physician Relocation, Medicaid BuyBack, Corporate tax packages, Governing Board facilitation, and Executive Team driven analytical AdHoc reporting functions
Tiffany & Co. DBA Little Switzerland - Senior Accounting Manager
City, STATE, 01/2003 - 05/2009
  • Demonstrated proficient analytical and problem-solving skills for monthly closing (start to finish), including preparation of financial statements, consolidating entries as well as reviewing and posting departmental entries to achieve corporate objectives for International multi-million dollar luxury Duty-Free jewelry retailer with over 30 locations
  • Conveyed opportunities and exposures related to preparation of inventory and AP adjustments, payroll accruals, insurance entries, recurring entries, corporate and subsidiary tax entries, intercompany entries and loan entries for monthly close; entries and detailed analysis for multiple entities in both USD and Foreign currencies
  • Implemented budget and expense controls and financial policies by analyzing income and expenditures across 30 US & International retail locations

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Resume Overview

School Attended

  • University of South Carolina - Columbia
  • Embry-Riddle Aeronautical University, University
  • University of Florida

Job Titles Held:

  • Director of Revenue & Reimbursement
  • Accounting Manager
  • Senior Accounting Manager

Degrees

  • Masters Certificate
  • Master of Science
  • Bachelor of Science

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