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Revenue Cycle Manager Resume Example

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Jessica Claire
, , 100 Montgomery St. 10th Floor
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Professional Summary

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.

Skills
  • Strategic planning
  • Verbal and written communication
  • Operations management
  • Business administration
  • Staff Management
Work History
08/2013 to Current
Revenue Cycle Manager Acadia Healthcare Gulfport, MS,
  • 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 Clerk The 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 Coder Sheridan 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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Resume Overview

School Attended
  • University of Illinois At Chicago
  • Harold Washington College
Job Titles Held:
  • Revenue Cycle Manager
  • Pathology Clerk
  • Medical Billing and Coder
Degrees
  • Bachelor of Science
  • Certificate, Medical Billing and Coding

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