Diligent Revenue Cycle Manager eager to utilize sixteen years of financial analysis and budget monitoring to bring immediate value. Highly skilled in managing billing cycle performance and executing financial reporting. Eager to offer a passion for process improvement and an unfailing work ethic to a new organization.
Skills
MS Word, Excel & Outlook McKesson & ZirMed Electronic Claim Programs Misys, Raintree 9.4 & Raintree 10.2
Delivering quality business solutions through strategic planning and effective management"
Direct and plan the billing operations for a team consisting of five employees in an organization that provides outpatient physical therapy services in two states.
Maintained an A/R over 4.5 million between both states with never being under 85% less than 90 days.
Developed a successful method of checking all outstanding charges before claims were submitted electronically.
All claims were submitted daily which allowed claims to be processed for payment within 2 days.
Hire, counsel, mentor, motivate, evaluate, discipline, reward, train, and assign and schedule employees' work.
Develop and maintain internal controls and procedures to promote the adherence of policies and regulations.
Conduct routine account activity quality audits to ensure accounts are being worked appropriately.
Oversee and streamline billing and collections processes across two states.
Prioritize and track assignments to handle multiple functions simultaneously to meet deadlines, and balance changing demands.
Analyze and investigate customer issues impacting on-time payment, and ensure corrective action is taken.
Prepare a weekly customer account summary for aged accounts receivables.
Committed to build customer confidence and solve customer problems quickly to increase customer satisfaction.
Attend and participate in meetings with management to exchange billing information containing to insurance reimbursement trends, as well as procedural problems.
Chair meetings with employees to inform on policy and procedure changes, and resolve problems.
Identify routine and complex billing problems, and device the most effective and efficient resolution.
Monitored revenue and compared to targets to address any variances., and the resolved actual-to-budget variances.
Evaluated revenue cycle processes and established actionable methods to increase productivity and efficiency.
Analyzed and reported on billing cycle data to inform management.
Set up and monitored payment plans and processed payments.
Monitored and maintained all providers credentialing with all Government and Commercial insurances.
Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
Provided revenue cycle process support to all clinical personnel, including resolving procedure challenges.
Business Office Area Manager Drayer Physical Therapy, 07/2005 to 04/2014 Drayer Physical Therapy Institute LLC – City, STATE,
Directed both the Front Office and Billing Office operations over thirty employees for twenty clinics in three states.
Oversaw claims submission, payment posting, accounts receivable follow-up, reimbursement management, records management, HR management, and office administration to ensure the entire office ran smoothly.
Recruited, hired, trained, and promoted four out of eighteen Business Office Area Manager's in three states.
Delegated tasks and reviewed employees' completed work or spot checked for policy compliance.
Ensured employee performance met or exceeded expectations.
Due to major growth in 2009, efficiently opened ten clinics in OH and four in TN while also manager over six clinics in KY.
Traveled weekly during a 24-month period and successfully trained employees which resulted in the promotion of four employees in the OH, TN, and KY clinics to positions of Business Office Area Managers.
After acquiring the first acquisition in 2007 at Hilton Head, SC, made an onsite visit to train employees in the Front Office and Billing Office on administrative and billing policies and procedures.
Oversaw collections and through diligence and strategic planning, collected 90% of A/R within 90 days.
Helped with contracting all clinics to become participating providers, and ensured the submission of clean claims and that they were submitted in a timely manner.
Worked closely with all Center Managers and Regional Vice Presidents and ensured the Front Office was maintained at least to a 92% arrival rate.
Worked effectively with the Clinical Service team to ensure Medicare guidelines were being followed.
Verified Medicare, HMO, Medicaid, and other third party insurance coverage.
Assured proper accounting procedures and controls were in place and followed.
Directed billing functions to include accurate and timely claims filing for all clinics.
Analyzed collections on a monthly basis, and monitored the process for the timely collection of patient payments and placed delinquent accounts into the collections process as outlined by policy.
Ensured sufficient office supplies were on hand to properly perform work without delay.
Kept the senior supervisor briefed on office activities, and actual or potential problems.
Presided over meetings with employees to update on changes in operational policies and procedures.
Processed the monthly financial statements, and produced variance reports for financial reporting.
Ensured records were accurately maintained and submitted, in a timely manner, and complied with federal and state regulations.
Maintained financial records to include cash receipts, cash disbursements, accounts receivable, accounts payable, and payroll ledgers.
Front Desk Receptionist/Billing and Collections, 03/2004 to 07/2005 Drayer Physical Therapy Institute LLC – City, STATE,
Performed daily billing and collections to obtain timely reimbursement for patient care services rendered.
Stayed current on ever-changing health insurance environment.
Correctly scheduled and tracked patients' appointments to reduce no-shows.
Collected and provided basic information to verify insurance benefits on a pending patient prior to the start of services; and re-verified on existing patients for new services.
Verified authorizations to ensure a business had workers' compensation insurance coverage.
Thoroughly counseled all patients to communicate insurance benefit tailored to each individual's services.
Followed procedures to precisely manually key in patient charges transactions to bill for services performed.
Received, sorted, and opened incoming mail and organized according to subject matter to prioritize actions.
Prepared and posted daily deposit to the system for insurance checks, credit card payments, and cash received.
Filed claims electronically using software that met requirements established by the HIPAA claim standard.
Applied attention to detail to accurately prepare HCFAs claims forms.
Monitored and reviewed computer-generated reports to identify outstanding accounts.
Followed up via telephone call to confer with patient for denials or outstanding accounts to pursue payment.
Prepared weekly and monthly reports regarding insurance amounts billed and collected for Corporate, generated for census, cash flow, tracking net revenue per visit and net revenue paid per visit.
Thoroughly answered customer questions regarding their accounts, and quickly resolved any issues.
Researched and resolved incorrect payments and other routine and complex errors.
Education and Training
Diploma: General Studies, Expected in 05/1989 Woodford County High School - Versailles, KY, GPA:
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School Attended
Woodford County High School
Job Titles Held:
Revenue Cycle Manager
Business Office Area Manager Drayer Physical Therapy
