RHIA-qualified professional with specialized Health Information Management education and experienced in revenue cycle management, A reliable Revenue Cycle Analyst known for successfully handling various tasks in deadline-driven environments.
Managing revenue cycle operation from patient access to patient accounting phase.
Provides ongoing analysis and support to scheduling and billing departments.
Solid knowledge and working experience of coding guidelines, medical terminology, ICD-10-CM, CPT/HCPCS, HCFA 1500, HIPAA, appeal processes, billing and insurance regulations and insurance benefits.
Reviewing employees' performances, hires new employees, manage performance improvement activities.
Managing activities of billing department to ensure smooth operations and to increase reimbursement by supervising submission of claims to various insurance companies both electronically and paper.
Oversee entire revenue cycle process from claims processing, billing, and accounts receivable, to denials and resolution.
Solid knowledge of basic accounting principles and business management to be able to effectively give direction to billing and coding office.
Strong negotiation skills to be able to effectively deal with customers and secure payment, as well as to be able to discuss finances of patients.
Manages maintenance of 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.
Working with third party healthcare payers to ensure increase in reimbursement and decrease in claim denial.
Determine root cause of payer rejections or delays in reimbursement.
Regular update on HIPAA and all other health information management issues and regulations.
Strong ability to communicate effectively with staff, colleagues, patients, physicians, and insurers in person, over telephone, and in writing.
Processing received electronic remittance advice and reviewing rejections or denial claims to determine validity of rejections and taking appropriate actions to resolve problems.
Adjusts patients' balances based on third-party reimbursement guidelines and contracts.
Develop and maintain reports for supervision of staff productivity and management of tasks unbilled.
Supported clinical team members with revenue cycle procedures and addressed issues as needed
12/2010 to 08/2013
Pathology ClerkThe University Of Kansas Hospital – Lawrence, KS,
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.
Processed correspondence, including post office pick-ups, sorting and distribution to appropriate parties.
Handled 50 customer calls per day to address customer inquiries and concerns.
08/2008 to 12/2010
Medical Billing and CoderSheridan Medical Center – City, STATE,
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.
Interacted with physicians and other healthcare staff to ask questions regarding patient services.
Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
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.
Implemented new coding procedures that reduced mistakes by 10% and simplified processes.
Reviewed medical records for completeness and filed records in alphabetic and numeric order
Education
Expected in 05/2015
Bachelor of Science: Health Information Management University of Illinois At Chicago - Chicago, IL GPA:
Expected in 07/2009
Certificate, Medical Billing and Coding: Harold Washington College - Chicago, IL, GPA:
Certifications
AHIMA-Approved Revenue Cycle Trainer
AHIMA-Registered Health Information Administrator (RHIA)
AWS Certified Solutions Architect – Associate
AWS Certified Cloud Practitioner
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