revenue cycle management supervisor resume example with 15+ years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • Home: (555) 432-1000
  • Cell:
Professional Summary

Analytical and patient focused health care professional with many years experience in revenue cycle management. Strong proficiency in financial strategies including on-boarding, verification, process improvement and departmental leadership focused on positive customer outcomes. Take a moment to review my profile on Linkedin ( )

Core Qualifications
  • Accomplished leadership
  • Independent judgment and decision making
  • Effective mentor and coach
  • Excellent Presentation skills
  • Customer focused
  • Quality improvement
  • HIPAA compliance
  • Medicare/ Medicaid statutes and regulations
  • Attention to detail
  • Root case analysis
Revenue Cycle Management Supervisor, 06/2001 to 10/2013
Option Care HealthFayetteville, NC,
  • HR functions: staff of 25 ; performance, disciplinary, payroll and career planning management.
  • Departmental Liaison for the Taleo on boarding team. Expert understanding of Kronos payroll system.
  • Utilized monthly team and individual meetings to build moral, solicit feedback and communicate new directives.
  • Communication, collaboration and Customer Service functions: communicate, clarify and train organizational changes and updates.
  • Work with Managed care team,providers, vendors and patients to resolve complex insurance reimbursement issues.
  • Routinely reviewed and updated departmental policies, procedures and programs.
  • Designated departmental subject matter expert. Member of Accredo Presidential Committee of Excellence.
  • Project leader assigned to train the reimbursement team to assist with pharmacy scheduling of Medco specialty patients.
  • Department Liaison to IT and UAT team for reimbursement system updates.
  • Work stream functions: Work with peers and other departments to improve efficiency; develop processes to improve quality and customer service.
  • As designated department SME worked with Directors, training department and QA to review, update and implement SOP changes as needed.
  • Member of project team assigned to align SOP of 3 divisions, assisted with training and on-boarding of back office team.
  • Finance functions: Analyzed multi million dollar AR, recommended and implemented strategies to meet or exceed departmental goals.
  • Member of the review and advisory team tasked with initial requirements and objectives for the Medi Finance system.
  • Managed various patient assistance programs that allowed patients to start or continue therapy.
Insurance Analyst, 11/1999 to 05/2001
Accredo Health GroupCity, STATE,
  • Analyzed, researched and compiled utilization data for internal and external reporting.
  • Routinely collaborated with department managers to correct problems and improve services.
  • Completed monthly QA audits and provided feedback via trend reporting.
  • Identified process improvements in the day-to-day functioning of the department.
  • Closely collaborated with management teams to develop process and policy improvements.
  • Responsible for training and development of staff.
  • Interpreted and communicated new or revised state medicaid, medicare and CMS policies to staff.
  • Facilitated an on-going assessment of patient/family needs for patients participating in an internal assistance program.
Patient Account Representative, 09/1997 to 10/1999
Nova Factor, IncCity, STATE,
  • Verified patient insurance benefits to insure payment prior to dispensing.
  • Obtained prior authorizations, coordinated with physicians, payers and members of the clinical care department.
  • Negotiated payment plans with patients.
  • Solicited payers to include our organization in their network or agree to a negotiated rate agreement.
  • Completed HCFA-1500, universal claim forms or special reimbursement forms for submission to payers.
  • Processed claims electronically through Emdeon and NDC systems.
  • Reviewed explanation of benefits and payment vouchers, compared them to verified benefits and calculated to determine that correct payment was received and posted correctly.
  • Submitted claims to secondary payers for coordination of benefits.
  • Followed up with payer when payments did not match benefits or were not received timely.
  • Reviewed contract documents to verify billing compliance.
  • Wrote and submitted payment appeals.
  • Negotiate payment settlements to close out delinquent accounts.
  • Completed quarterly review of accounts to identify and resolve bad debt.
  • Member of the Accredo Presidential Committee for Excellence.
  • Reduced AR for discharged patients from $4 million to less than $250,000.
  • Designated Department Subject matter expert for organizational, system and process issues.
  • Traveled to India to assist with on-boarding of back office team.
Bachelor of Arts: Social Sciences and Business Administration , Expected in
Nazareth College of Rochester - Rochester, NY

Specialization Certificate: Introduction to Project Management Principles and Practices, Expected in
Coursera: University of California, Irvine - ,
Professional Development

PTCB - Certified Pharmacy Technician 2001 to present

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Resume Overview

School Attended

  • <font><font><font>Nazareth College of Rochester</font></font></font>
  • <font><font><font>Coursera: University of California, Irvine</font></font></font>

Job Titles Held:

  • Revenue Cycle Management Supervisor
  • <font><font>Insurance Analyst</font></font>
  • <font><font>Patient Account Representative</font></font>


  • <font><font><font>Bachelor of Arts</font></font></font>
  • <font><font><font>Specialization Certificate</font></font></font>

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