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Healthcare Revenue Cycle Analyst Resume Example

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HEALTHCARE REVENUE CYCLE ANALYST
Professional Summary

RHIA-qualified, critical thinking professional with specialized Health Information Management and experience in revenue cycle management. A reliable Revenue Cycle Analyst known for successfully handling various tasks in deadline-driven environments.

Skills
  • Microsoft Word, Excel, Power-Point, and Access
  • Letters
  • ICD-9-CM, ICD-10-CM/PCS/CPT-4 procedural's
  • Accounting
  • Diagnosis
  • Coding
  • Supervising
  • Reports for senior management
  • Payment plan processing
  • Insurance
  • Proficient in EHR System (eClinicalWorks, & Cerner)
  • Medical Billing
  • Contracts
  • Documentation
  • Quality improvement
  • Trainer
  • Verbal and written communication
Work History
August 2013-CurrentHealthcare Revenue Cycle Analyst | Sheridan Medical Center | Chicago, IL
  • Analyzes billing and accounts receivable reports. Identifies trends, categories of aged receivables and provides feedback to stakeholders to improve results.
  • Analyzes workflow and operational procedures of billing department to ensure smooth operations and to improved reimbursement.
  • Analyzes ICD-10-codes assignment to medical claims by using ICD-10-CM code book and encoder software system.
  • Prepares and distributes monthly reimbursement/revenue cycle reports for departments.
  • Ensures payment is received, credited and recorded at contracted rates.
  • Identifies and researches discrepancies through data analytics and root cause analysis to improve upstream processes.
  • Maintains charge master review of pricing through Medicare fee schedule payment.
  • Maintains annual updating of charge master and CPT Codes.
  • Monitoring and supervising day to day activities of coding process to ensure that standard coding guidelines are followed.
  • Applying documentation guidelines, ICD-10-CM, CPT-4 and HCPCS classification systems and coding guidelines to analyze medical record documentation.
  • Working with third party healthcare payers to identify their new requirement and guidelines.
  • Reviews, modifies and recommends changes to policies and procedures to improve Accounts Receivables Days.
  • Reviews Medicare and Medicaid billing requirements regularly to decrease claims denies.
  • Managing revenue cycle operation from patient access to patient accounting phase, by tracking claims from point of claim submission through payment collection.
  • Determine root cause of payer rejections or delays in reimbursement.
  • Resolve 90% dispute claims and increase reimbursement, by getting to root of denial claims.
  • Processing received electronic remittance advice and reviewing rejections or denial claims to determine validity of rejections and taking appropriate actions to resolve problems.
  • Adjusting patients' balances based on third-party reimbursement guidelines and contracts.
December 2010-August 2013Slide File Clerk | Northwestern Memorial Hospital | Chicago, IL
  • Processed microscopic slides request, for patients and pathologies.
  • Used Cerner to process patients' requests and view pathology results.
  • Filled microscopic slides in numerical orders.
  • Pulled, refilled and delivered microscopic slides to pathologies.
  • Increased customer satisfaction by resolving customer issues.
  • Transported Microscopic slides to pathologies offices in timely manner
  • Handled 50 calls per day to address customer inquiries and concerns.
August 2008-December 2010Medical Billing Coder | Sheridan Medical Center | Chicago, IL
  • Handled coding of all diagnosis, procedures and professional services applying accurate and descriptive ICD9-CM, CPT, E&M, and HCPCS code for reimbursement purposes.
  • Assigned codes on Emergency room visits, outpatient and inpatient hospitalizations.
  • Posted payment from Medicare, Medicaid and other third-party insurances to patients' account through Billing Software.
  • Called Medicare local contractor for claims adjustment.
  • Filled away hard copies of Explanation of Benefit reports.
  • Sent out patients' statements every month.
  • Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
  • Implemented new coding procedures that reduced mistakes by 10% and simplified processes.
  • Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
  • Interacted with physicians and other healthcare staff to ask questions regarding patient services.
  • Reviewed outpatient records and interpreted documentation to identify all diagnoses and procedures.
  • Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
Education
May 2015Bachelor of Science: Health Information ManagementUniversity of Illinois At Chicago, Chicago, IL
Certificate, Medical Billing and Coding: Harold Washington College, Chicago, IL
Certifications

AHIMA-Registered Health Information Administrator (RHIA)

AHIMA-Approved Revenue Cycle Trainer

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Resume Overview

Companies Worked For:

  • Sheridan Medical Center
  • Northwestern Memorial Hospital

School Attended

  • University of Illinois At Chicago
  • Harold Washington College

Job Titles Held:

  • Healthcare Revenue Cycle Analyst
  • Slide File Clerk
  • Medical Billing Coder

Degrees

  • Bachelor of Science : Health Information Management
    Certificate, Medical Billing and Coding :

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