Revenue Cycle Manager Resume Example

A driven and compassionate health care professional with 20 years experience in  fast-paced Patient Account billing companies , Health insurance Member billing and hospital environment. Accountable and responsible with a strong focus on  Revenue cycle reconciliation,patient collection and supervising  staffs of 20 or more with exceptional billing and relationship-building skills.

• Possess excellent verbal and written communication skills
• Business development for team and work independently as well
• Budget management, Product development and project management
• Possess good management and organizational skills
• Ability to train and Mentor teams 
• Vendor management, Medicare/Medicaid compliance and strategic partnerships
•  Insurance State &Member billing including Child Health plus, Quality Health plan, Essential plan, ADAPT, Manage Long term care, Medicaid & Medicare . Hospital billing include inpatient  & out Patient, Patient Account billing for  various specialist such as Behavioral/ Mental Health,  Nursing home, Home care, Ob/GYN, Orthopedics, Oncology, Cardiology, internal Medicine, Urology, Pharmacy, Laboratory, Radiology, DME Billing, 
• specialize in Medicare, Medicaid, BCBS Manage care medicaid/ Medicare, commercial, Worker compensation, No Fault & Local
• Excellent knowledge of ICD-9 ,CPT-4 revenue cycle  compliance & Audit
• Expertise in electronic exchange of healthcare information transactions directly to a payer(s) or via a clearinghouse.  Ex: 837, 270/271

• Deloitte 2014 Year End Audit
• Child Health Plus A133 Earnest &Young  2014 Compliance Audit    
• QHP Reconciliation Audit for 2014 to 2015
• Department of Health  2015 audit For Senior Health Partner
• The Billing Management project envisions replacing the current Structure/ systems, which were designed to automate the traditional billing teams transaction responsibilities of administering Macess , invoicing and check tracking, with a value-creating system that more fully enables the billing to participate in the strategic activities of the company. These value-creating opportunities consist of the following components
• Workforce Analytic/Performance Management. Looking beyond standard reporting metrics, Workforce Analytic should enable management to track and evaluate performance across key, multi-disciplinary metrics such as Check posting margin, customer data, operational productivity, member check tracking coming from the offsite business office activity  training and educating the staffs
• Project Objectives
• The project objective was to replace an aging billing department and failing software system with a state-of-the-art Human billing Management System to meet current business needs and to allow for the achievement of future business strategies including growth.

Member of the AAPC since 2012