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Professional Summary
Methodical Revenue Cycle Specialist with strong attention to detail and in-depth understanding of billing procedures. Excellent planning and problem-solving abilities. Prepared to bring 20 years of related experience to a dynamic position with room for career growth.
Skills
Leadership
Detail-oriented
Collaboration
Supervision
Team building
MS Office
Revenue cycle analysis
Revenue cycle solutions
Revenue cycle management
Technical integration
Lifecycle Management
Account and revenue tracking
Debt collection procedures
Managing records
Work History
02/2014 to CurrentRevenue Cycle Integration SpecialistNorthside Hospital | Holly Springs, GA,
Act as the primary leader for the integration of assigned ambulatory practices with responsibilities for optimizing a range of revenue cycle systems such as Cerner, McKesson, eClinicalWorks, Centricity, Greenway, etc. to improve revenue cycle performance.
Engage with Revenue Cycle Executive Leadership to identify opportunities to enhance operational workflow efficiencies, improve systems functionality, increase patient satisfaction, and reduce costs associated with revenue cycle functions.
Develop departmental strategies to meet Revenue Cycle and Northside goals and performance metrics.
Participate in developing the departmental long-term and short-term goals, objectives, plans, policies, and procedures.
Identify, communicate, and align overall strategy for department improvement across the system. Develop departmental strategies to meet Revenue Cycle and Northside goals and performance metrics.
Ensure that ancillary department resources focus on projects aligned with Revenue Cycle and Northside strategic, financial, and patient service objectives. Lead efforts to plan and implement solutions to address those opportunities.
Formulate and successfully execute rollout initiatives while effectively managing projects tasks, timelines, and milestones
Take a leadership role in technology implementations affecting the Revenue Cycle. Assist in the identification of innovative technologies that will improve revenue cycle operations.
Used critical thinking to break down problems, evaluate solutions and make decisions.
Coordinate and lead onboarding and setup of Northside Hospital's Point of Service processes; Identify and resolve issues through cross-functional teams.
Formulate and administer system-level policies and procedures related to revenue cycle functions.
Identified and resolved payment issues between patients and providers.
Balanced and reconciled accounts.
02/2014 to 10/2016Insurance Verification SupervisorNorthside Hospital | City, STATE,
Supervised 35 team members consisting 4 areas: Pre-Obstetrics, Current, Post and Infusion Therapy
Lead departmental team cross-training Pre-certification Team achieved a denial rate of less than 1% across 66,162 accounts (FY2014)
Lead 3rd party vendors coordination and management of accounts with total charges over $2.5 Mil
Implemented quarterly department team building events
Created Authorization Tracking tools
Assessed and revamped precertification processes across multiple departments
Developed improvement methods and tools to streamline processes for better tracking and trending of Medicaid accounts
Responsible for Relationship Management with internal and external customers
06/2007 to 01/2014Call Center in Patient Accounting SupervisorOrlando Health Hospital | City, STATE,
Oversaw employee performance to foster accurate prioritization and achievement of sales and productivity goals.
Monitored call quality and provided individual constructive feedback to enhance performance and address areas in need of improvement.
Supervised 28 team members in the Call Center FY2012, Call Center handled 96,536 calls, 78,567 non-transfer calls and an abandon rate of 10% for 8 facilities
Handled and resolved 23% of escalated patient and/or insurance calls with a “Patient First” attitude
Implemented staff recognition program by rewarding staff exceeding 100% productivity, 100% QA score and collections of $5,500 or more monthly
04/2002 to 06/2007Quality Assurance Analyst in Patient AccessOrlando Health | City, STATE,
Lead 13 team members in the Emergency Department on 1st shift
Performed daily audits on accuracy of patient data, for the financial services department and operational areas which improved accuracy of patient data by 13%
Assisted with the implementation and testing of a registration software RQI (Registration Quality Improvement) that increase the organizations revenue 1.3 million last quarter
Created an excel spread sheet that automatically tally representative audit score for cumulative summaries to email to area managers
Maintained knowledge of CPT and ICD-9 codes and logged appropriately in Affinity system for timely reimbursement
Education
Expected in Bachelor of Science | Business AdministrationUniversity of Central Florida, Orlando, FLGPA:
Expected in Master of Science | Health AdministrationWebster University, St Louis, MOGPA:
Certifications
Certified Healthcare Access Associate (CHAA)
Certified Patient Access Representative (CPAR)
Certified Financial Counselor (CFC)
Hospital Systems: Affinity, Passport, DDE Supersession, Availity, Sunrise, EDI and TDS, GE, ePremise, STAR, Worklist Tool, DaVinci and OneCall
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